Individual
SCOTT M FREDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1190 W MAIN ST STE 200, VEVAY, IN 47043-3665
(812) 427-9564
(812) 427-9621
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01052679
IN
208000000X
Pediatrics Physician
01052679
IN
208D00000X
General Practice Physician
01052679
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200257500A
—
IN
05
—
64018054
—
KY
Enumeration date
06/30/2006
Last updated
10/09/2025
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