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Individual

PHILIP FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
75 CLEARWATER DR, SUITE 106, FALMOUTH, ME 04105-1339
(207) 400-8570
(207) 400-8580
Mailing address
75 CLEARWATER DR, SUITE 106, FALMOUTH, ME 04105-1339
(207) 400-8570
(207) 400-8580

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
012049
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046861
ANTHEM
ME
05
301260099
ME
01
3391930
AETNA
05
402700099
ME
01
C66229
HARVARD PILGRIM HEALTHCAR
Enumeration date
01/17/2007
Last updated
10/23/2009
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