Individual
DR. KEVIN DALE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, M.C. 20-07, DANVILLE, PA 17822-9800
(570) 271-6301
Mailing address
100 N ACADEMY AVE, M.C. 20-07, DANVILLE, PA 17822-9800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD436166
PA
Other
Enumeration date
07/21/2008
Last updated
06/09/2020
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