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Individual

WILLIAM HOWARD FREDERICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1700 UNIVERSITY AVE W FL 6, SAINT PAUL, MN 55104
(651) 232-5321
Mailing address
1690 UNIVERSITY AVE W STE 370, SAINT PAUL, MN 55104-3723
(651) 232-5321

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
58337
MN
208100000X
Physical Medicine & Rehabilitation Physician
58337
MN
208VP0014X
Interventional Pain Medicine Physician
Primary
58337
MN

Other

Enumeration date
05/06/2013
Last updated
06/13/2018
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