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Individual

DR. WILLIAM H FREDRIKSSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PHD

Contact information

Practice address
1921 WALDEMERE ST STE 310, SARASOTA, FL 34239-2941
(941) 917-5400
(941) 917-5420
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
M8037
ID
208800000X
Urology Physician
Primary
ME154478
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010153906
BS MERIDIAN
ID
01
000010153908
BS NAMPA
ID
01
76706
BC MERIDIAN
ID
05
805784300
ID
01
B5442
BC NAMPA
ID
01
P00288611
RR MEDICARE
ID
Enumeration date
10/21/2005
Last updated
01/31/2022
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