Individual
MR. WILLIAM R FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 IRVING ST NW, SUITE 304, WASHINGTON, DC 20010-2993
(202) 291-6423
(202) 291-0691
Mailing address
106 IRVING ST NW, SUITE 304, WASHINGTON, DC 20010-2993
(202) 291-6423
(202) 291-0691
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101051734
VA
207R00000X
Internal Medicine Physician
Primary
4502
DC
207R00000X
Internal Medicine Physician
D0007970
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02214300
—
DC
01
—
413758
CAREFIRST BC BS OF MD
MD
01
—
6235
BLUE CROSS BLUE SHIELD
DC
Enumeration date
07/13/2006
Last updated
12/26/2007
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