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NPI Code Detail

MEDICARE: DANN J FREDRICKSON MD

MEDICARE: DANN J FREDRICKSON MD
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
1207R00000XInternal Medicine Physician114303MO

General Provider Information

NPI Number : 1215934203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANN J FREDRICKSON MD
Provider Business Mailing Address
First Line : 5400 N OAK TRFY
Second Line : SUITE 200
City : KANSAS CITY
State : MO
Zip : 64118-4688
Country : US
Telephone Number : 816-453-0900
Fax Number : 816-453-6271
Provider Business Practice Location Address
First Line : 5400 N OAK TRFY
Second Line : SUITE 200
City : KANSAS CITY
State : MO
Zip : 64118-4688
Country : US
Telephone Number : 816-453-0900
Fax Number : 816-453-6271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 09/26/2011

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Directions to “ DANN J FREDRICKSON MD” Practice Location

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