PAUL FREDERICK (NPI# 1790881290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790881290 |
Entity Type | Individual |
Full Name | PAUL FREDERICK |
Practice Address |
02957 73rd St South Haven MI 49090-9364 |
Practice Telephone | 2696379099 |
Practice Fax Number | 2696379224 |
Mailing Telephone | 2696379099 |
Mailing Fax Number | 2696379224 |
Enumeration Date | 2006-09-15 |
Last Update Date | 2008-03-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
M15501011004 | MI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 4800853 | 05 | |
MI | BLUE CROSS BLUE SHIELD | OHO1023 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366735623 | Paul Adam Frederick | Ophthalmology | 401 Meridian St N Ste 200, Huntsville, AL 35801-4719 | 2011-05-19 |
1518921782 | Paul L Frederick | Surgery | 500 Medical Arts Bldg, Suite 510, Kittanning, PA 16201-7137 | 2006-04-14 |
1568004752 | Paul Frederick | Specialist/Technologist | 6601 Montana Ave Ste Gandh, El Paso, TX 79925-2155 | 2019-10-09 |
1518056852 | Paul E. Frederick | Social Worker | 1130 Vester Ave, Suite C, Springfield, OH 45503-7302 | 2006-10-12 |
1326044660 | Paul Kenneth Frederick | Internal Medicine | 8902 N Meridian St, Ste 225, Indianapolis, IN 46260-5382 | 2005-06-22 |
Street Address |
02957 73RD ST |
City | SOUTH HAVEN |
State | MI |
Zip Code | 49090-9364 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407058209 | Orthopedic Physical Therapy Specialist LLC | Clinic/Center | 02957 73rd St, South Haven, MI 49090-9364 | 2007-06-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295234490 | Katara Therapy, LLC | Social Worker | 13560 76th Street, Suite 3, South Haven, MI 49090 | 2018-02-03 |
1487022091 | Kevin E. Ferrell | Physician Assistant | 955 S. Bailey Avenue, South Haven, MI 49090 | 2015-09-14 |
1942638002 | Birdie Farley | Chore Provider | 26725 M-140 Hwy, South Haven, MI 49090 | 2013-10-28 |
1730514910 | Rebecca A. Bennett | Counselor | 1675 Phoenix Road, Suite 9, South Haven, MI 49090 | 2013-09-06 |
1902149818 | Bronson South Haven Hospital | Emergency Medicine | 970 S Bailey Ave, South Haven, MI 49090 | 2013-03-28 |
1265629927 | Cecilia Liz Vives Vasquez | Physical Therapist | 23701 Red Arrow Hwy, Mattawan, MI 49090 | 2007-09-26 |
1518089788 | Donald Jam,es Buckley | Pharmacist | 955 S Bailey, South Haven, MI 49090 | 2007-04-06 |
1366568966 | Norman M Maly | Dentist | 05055 Blue Star Hwy, South Haven, MI 49090 | 2007-03-22 |
1639264062 | Deborah Sue Distefano | Pharmacy Technician | 512 Phoenix Street, South Haven, MI 49090 | 2006-10-03 |
1053357897 | Stephen Earl Tolen | Chiropractor | 325 Superior St., South Haven, MI 49090 | 2006-06-21 |
Find all providers in zip 49090 |
Taxonomy Code | 261QP2000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Physical Therapy |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407058209 | Orthopedic Physical Therapy Specialist LLC | Clinic/Center | 02957 73rd St, South Haven, MI 49090-9364 | 2007-06-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629679485 | Thrive Physical Therapy | Clinic/Center | 835 Mason St Ste A245, Dearborn, MI 48124-2231 | 2020-11-06 |
1700484482 | Redford Physical Therapy LLC | Clinic/Center | 25136 W 6 Mile Rd, Redford, MI 48240-2102 | 2020-10-14 |
1740894500 | Sara Sue Laisure | Clinic/Center | 1105 E 8th St, Traverse City, MI 49686-2936 | 2020-08-31 |
1578176269 | Pro-line Physical Therapy, LLC | Clinic/Center | 25899 W 12 Mile Rd Ste 335, Southfield, MI 48034-8343 | 2020-08-24 |
1326650011 | Physical Therapy Center for Sports and Performing Arts, Pllc | Clinic/Center | 30475 Stephenson Hwy, Madison Heights, MI 48071-1615 | 2020-08-23 |
1770194607 | Restorative Rehabilitation Inc | Clinic/Center | 9228 Pelham Rd, Taylor, MI 48180-3832 | 2020-08-13 |
1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
1114537719 | Axpert Rehab Care, LLC | Clinic/Center | 22830 Kelly Rd, Eastpointe, MI 48021-2072 | 2020-08-07 |
1619586898 | Right Health, PC | Clinic/Center | 28345 Beck Rd Ste 412, Wixom, MI 48393-4745 | 2020-07-23 |
1497378368 | Launch Pediatric Rehab | Clinic/Center | 13448 Greenbriar Dr, Grand Haven, MI 49417-9161 | 2020-05-26 |
Find all providers with the same taxonomy |
City | SOUTH HAVEN |
Zip Code | 49090 |
Please comment or provide details below to improve the information on PAUL FREDERICK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.