Individual
DR. FREDERICK KRISTIAN STORM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
S7698A LUCILLE LN, MERRIMAC, WI 53561-9793
(608) 493-2767
Mailing address
S7698A LUCILLE LN, MERRIMAC, WI 53561-9793
(608) 493-2767
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
28443-020
WI
174400000X
Specialist
BS8237390
WI
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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