Individual
DR. FRED E KOERNER
Active
Individual
DR. FRED E KOERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
000704
CT
103TC0700X
Clinical Psychologist
Primary
000704
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680001134
MEDICARE
CT
Enumeration date
02/08/2007
Last updated
09/05/2014
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