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Individual

DOUGLAS C FINEFROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3000 MACK RD, FAIRFIELD, OH 45014-5335
(513) 870-7001
(513) 603-8174
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-3547

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB09066300
NJ
207P00000X
Emergency Medicine Physician
34008054
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000316069
BCBS FAIRFIELD
OH
05
2424746
OH
01
P00083370
RR MEDICARE FAIRFIELD
Enumeration date
05/12/2006
Last updated
01/26/2021
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