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General NPI Number Information
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NPI Number | 1629484902
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Entity Type | Individual
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Provider Name | FREDERICK HAROLD DO
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Gender | Male
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 527 EISENHOWER DRIVE
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City | SAVANNAH
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State | GA
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Zip | 31406
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Country | US
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Telephone | 912-819-9100
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Fax | 912-819-9101
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Provider Business Mailing Address
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Address Line | 836 E. 65TH STREET SUITE 22
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-819-7878
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Fax | 912-819-3320
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.012118
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 80159
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License Number State | GA
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