MEDICARE: FREDERICK A FIEDLER M.D.

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	207R00000X	Internal Medicine Physician	MD16945	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3144525	OTHER	TN	BCBST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598733545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK A FIEDLER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 383260
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38183-3260
Country	:	US
Telephone Number	:	901-767-6175
Fax Number	:

Provider Business Practice Location Address
First Line	:	6263 POPLAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4736
Country	:	US
Telephone Number	:	901-761-6157
Fax Number	:

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/09/2007

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