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General NPI Number Information
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NPI Number | 1083032759
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Entity Type | Organization
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Legal Business Name | ROBERT S. FREDERICKS MD LTD.
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 1495 RIDGEVIEW DR
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City | RENO
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State | NV
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Zip | 89519-6346
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Country | US
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Telephone | 775-826-9300
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Fax | 775-826-9301
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Provider Business Mailing Address
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Address Line | 1495 RIDGEVIEW DR
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City | RENO
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State | NV
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Zip | 89519-6346
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Country | US
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Telephone | 775-826-9300
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Fax | 775-826-9301
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT S FREDERICKS
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Credential | M.D.
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Telephone | 775-826-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 4014
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License Number State | NV
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