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General NPI Number Information
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NPI Number | 1033177415
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Entity Type | Individual
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Provider Name | FREDERICK FIESSELER D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 100 MADISON AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6136
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Country | US
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Telephone | 800-290-5309
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Fax | 803-434-4354
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Provider Business Mailing Address
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Address Line | PO BOX 7313
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City | COLUMBIA
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State | SC
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Zip | 29202-7313
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Country | US
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Telephone | 800-290-5309
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Fax | 803-434-4354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MB71344
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License Number State | NJ
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