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Individual

DR. FREDERIC FRIES BAHNSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
188 MEDICAL PARK DRIVE, SUITE B, BREVARD, NC 28712
(828) 884-6702
(828) 884-6925
Mailing address
188 MEDICAL PARK DRIVE, SUITE B, BREVARD, NC 28712
(828) 884-6702
(828) 884-6925

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18599
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1007740
UNITED HEALTH CARE
NC
01
10409
BLUE CROSS BLUE SHIELD
NC
01
80389
MEDCOST
NC
05
8910409
NC
Enumeration date
05/31/2005
Last updated
07/09/2007
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