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NPI Code Detail

MEDICARE: FREDERICK JAMES ECHTERNACHT MD

MEDICARE: FREDERICK JAMES ECHTERNACHT 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 Physician13578NE

General Provider Information

NPI Number : 1821058843
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK JAMES ECHTERNACHT MD
Provider Business Mailing Address
First Line : 2201 N BROADWELL AVE
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-2153
Country : US
Telephone Number : 308-382-3660
Fax Number : 308-385-2738
Provider Business Practice Location Address
First Line : 2201 N BROADWELL AVE
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-2153
Country : US
Telephone Number : 308-382-3660
Fax Number : 308-385-2738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 04/29/2009

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