Individual
FREDERIC DEWIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 ROUTE 72 W STE 300, MANAHAWKIN, NJ 08050-2483
(609) 597-6513
(609) 597-4593
Mailing address
1301 ROUTE 72 W STE 300, MANAHAWKIN, NJ 08050-2483
(609) 597-6513
(609) 597-4593
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MA59306
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5556902
—
NJ
01
—
P00297585
RAILROAD MEDICARE
NJ
Enumeration date
06/23/2006
Last updated
08/29/2012
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