Individual
FREDERICK KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
67918
WI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
67918
WI
Other
Enumeration date
05/19/2016
Last updated
02/03/2021
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