Individual
FREDERICK A CRUICKSHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 COMMERCE CENTRE DR, SUITE 103, HUNTERSVILLE, NC 28078-5869
(704) 948-8582
(704) 948-8572
Mailing address
103 COMMERCE CENTRE DR, SUITE 103, HUNTERSVILLE, NC 28078-5869
(704) 948-8582
(704) 948-8572
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006-01174
NC
207RI0200X
Infectious Disease Physician
Primary
2006-01174
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006-01174
STATE LICENSE
NC
05
—
5908056
—
NC
Enumeration date
07/19/2006
Last updated
03/12/2025
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