Organization
G I INC
Active
Organization
G I INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL WILLIAM FREDERICKSON MD (PHYSICIAN)
(314) 645-1344
Entity
Organization
Contact information
Practice address
1035 BELLEVUE AVE, SUITE 204, SAINT LOUIS, MO 63117-1854
(314) 645-1344
(314) 645-6457
Mailing address
1035 BELLEVUE AVE, SUITE 204, SAINT LOUIS, MO 63117-1854
(314) 645-1344
(314) 645-6457
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R8D71
MO
Other
Enumeration date
05/09/2007
Last updated
10/20/2011
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