Individual
FRED G FEDOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 E FERN AVE, FOLEY, AL 36535-2806
(251) 943-6003
(251) 943-2429
Mailing address
113 E FERN AVE, FOLEY, AL 36535-2806
(251) 943-6003
(251) 943-2429
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD028333E
PA
207YS0123X
Facial Plastic Surgery Physician
Primary
15147
AL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
15147
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011684000002
—
PA
Enumeration date
04/26/2006
Last updated
07/21/2022
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