Individual
FREDERICK POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0263
(860) 263-0267
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0263
(860) 263-0267
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017871
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001178714
—
CT
01
—
010017871CT02
BCBC CT
—
01
—
017871
MEDICAL LICENSE
CT
Enumeration date
12/23/2005
Last updated
03/07/2023
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