Doctor Name: | DR. JAMES ROBERT FREDERICK |
NPI Number: | 1407913023 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 2008-01176 |
Business Practice Address: | 325 N 15th St Hahnemann University Hospital, Dept Of Emer Med Philadelphia, PA - 191021030 |
Business Phone Number: | 2158502550 |
Business Fax Number: | |
Mailing Address: | 618 Garden Rd, GLENSIDE |
State: | PA |
Postal Code: | 190385110 |
Phone Number: | 2158502550 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 12/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2008-01176 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |