Individual
DR. MARY FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
(651) 254-9673
Mailing address
1314 ADAMS ST NE, MINNEAPOLIS, MN 55413-1440
(612) 580-3233
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55278
MN
208M00000X
Hospitalist Physician
55278
MN
Other
Enumeration date
05/06/2009
Last updated
05/22/2019
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