Healthcare Provider Details

I. General information

NPI: 1770549842
Provider Name (Legal Business Name): FREDRICK G. DUBOIS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. ARMY MEDICAL DEPARTMENT ACTIVITY HEIDELBERG CMR 442
APO AE
09042-0130
DE

IV. Provider business mailing address

CMR 442, BOX 389
APO AE
09042
DE

V. Phone/Fax

Practice location:
  • Phone: 011496221172078
  • Fax: 011496221172824
Mailing address:
  • Phone: 011496221172084
  • Fax: 011496221172824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1872
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: