Individual
DR. FRED CHARLES VANNATTA
Active
Individual
DR. FRED CHARLES VANNATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
041448
CT
2085R0202X
Diagnostic Radiology Physician
Primary
141442
NY
2085R0202X
Diagnostic Radiology Physician
25MA07673300
NJ
2085R0202X
Diagnostic Radiology Physician
31689
AZ
2085R0202X
Diagnostic Radiology Physician
A23570
CA
2085R0202X
Diagnostic Radiology Physician
MD041298E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
906S9WQ111
MEDICARE
NY
Enumeration date
09/02/2006
Last updated
12/06/2007
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