Individual
NICHOLAS LORNE FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
(843) 792-1414
Mailing address
165 ASHLEY AVE # MSC908, CHARLESTON, SC 29425-8905
(843) 792-1086
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MMD.88225
SC
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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