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General NPI Number Information
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NPI Number | 1336465855
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Entity Type | Individual
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Provider Name | MICHAEL FREDERICK MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 101 N CLEMATIS ST
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5554
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Country | US
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Telephone | 561-672-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 333 HUGO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2605
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Country | US
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Telephone | 805-264-2514
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME127493
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License Number State | FL
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