Individual
JOHN RICHARDS FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1237 HARDING PL, STE 3100, CHARLOTTE, NC 28204
(704) 373-0212
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2016-01623
NC
208600000X
Surgery Physician
2016-01623
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2016-01623
NC
Other
Enumeration date
01/04/2007
Last updated
07/16/2024
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