Individual
MR. FREDERIC CHARLES HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11550 STATE ROUTE 500, PAULDING, OH 45879-9173
(419) 399-2630
(419) 782-8853
Mailing address
11550 STATE ROUTE 500, PAULDING, OH 45879-9173
(419) 399-2630
(419) 782-8853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-00-5455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0853170
—
OH
Enumeration date
10/12/2005
Last updated
03/03/2010
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