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Individual

DR. KRISELL D FEDRIZZI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
325 N MAIN ST STE 206, SPRINGBORO, OH 45066-8005
(937) 949-4713
(855) 460-5802
Mailing address
PO BOX 194, SPRINGBORO, OH 45066-0194
(937) 949-4713
(855) 460-5802

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34004949F
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000227847
ANTHEM
OH
01
0120677
UNITED HEALTHCARE
OH
05
0769726
OH
01
080191722
RAILROAD MEDICARE
OH
01
34004949F
MEDICAL LICENSE
OH
01
421534506029
CARESOURCE
OH
01
649246
AETNA
OH
01
D0494904
HUMANACHOICECARE
OH
Enumeration date
06/01/2005
Last updated
07/03/2024
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