MEDICARE: RAGINI FREDRICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0210X	Pediatric Nephrology Physician	7554	NV

General Provider Information

NPI Number	:	1528475340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAGINI FREDRICH

Provider Business Mailing Address
First Line	:	11630 MORNING GROVE DRIVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11630 MORNING GROVE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1539
Country	:	US
Telephone Number	:	702-498-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2014
Last Update Date	:	07/14/2014

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Directions to “ RAGINI FREDRICH ” Practice Location

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