Individual
PAUL L FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 MEDICAL ARTS BLDG, SUITE 510, KITTANNING, PA 16201-7137
(724) 954-6115
(724) 548-5683
Mailing address
500 MEDICAL ARTS BLDG, SUITE 510, KITTANNING, PA 16201-7137
(724) 954-6115
(724) 548-5683
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD006827E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006359850003
—
PA
Enumeration date
04/14/2006
Last updated
11/02/2009
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