Individual
DR. FREDERICK STUART MITTLEMAN
Active
Individual
DR. FREDERICK STUART MITTLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101022130
VA
2084P0800X
Psychiatry Physician
036762
CT
2084P0800X
Psychiatry Physician
Primary
04-15284
KS
2084P0800X
Psychiatry Physician
12229
NE
2084P0800X
Psychiatry Physician
22730
CO
2084P0800X
Psychiatry Physician
36080
AZ
2084P0800X
Psychiatry Physician
D13793
MD
2084P0800X
Psychiatry Physician
R2C29
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09752017
BLUE SHIELD OF KC
MO
01
—
610289
BLUE SHIELD OF KANSAS
KS
01
—
662060001
TRICARE
—
Enumeration date
07/25/2006
Last updated
10/26/2011
Update your record
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