Individual
MARY A FREDERICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1316 BROADWAY SE, ALBUQUERQUE, NM 87102
(505) 768-5450
(505) 842-1185
Mailing address
2001 N CENTRO FAMILIAR SW, ALBUQUERQUE, NM 87105
(505) 768-5450
(505) 842-1185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81191
NM
Other
Enumeration date
12/02/2005
Last updated
07/08/2007
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