Individual
DAVID FREDERICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1753 E MARKET ST, SUITE 1, WARREN, OH 44483-6672
(330) 373-6903
(330) 399-1055
Mailing address
1753 E MARKET ST, SUITE 1, WARREN, OH 44483-6672
(330) 373-6903
(330) 399-1055
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35040244
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411987
—
OH
Enumeration date
02/15/2007
Last updated
11/16/2007
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