Individual
FREDERICK H MABRY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 W ILLINOIS AVE, SOUTHERN PINES, NC 28387-5808
(910) 692-2444
Mailing address
195 W ILLINOIS AVE, SOUTHERN PINES, NC 28387-5808
(910) 692-2444
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2011-00475
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114998150
—
NC
Enumeration date
06/02/2008
Last updated
09/03/2020
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