MEDICARE: MRS. FREDRICA WALDBURG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	059044653	GA

General Provider Information

NPI Number	:	1144152976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FREDRICA WALDBURG

Provider Business Mailing Address
First Line	:	6205 ABERCORN ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-5527
Country	:	US
Telephone Number	:	912-703-3629
Fax Number	:

Provider Business Practice Location Address
First Line	:	6205 ABERCORN ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-5527
Country	:	US
Telephone Number	:	912-703-3629
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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