Individual
DR. FREDERICK J MENICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1102 N EL DORADO PL, TUCSON, AZ 85715-4606
(520) 881-4525
(520) 881-2962
Mailing address
1102 N EL DORADO PL, TUCSON, AZ 85715-4606
(520) 881-4525
(520) 881-2962
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11308
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22953501
—
AZ
Enumeration date
09/07/2005
Last updated
07/08/2007
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