Frederick, John

Frederick, John is an individual health care provider with primary practice located at 24 Joliet St , Dyer IN 46311-1705. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Frederick, John can be contacted via phone (219) 865-2141.

Contact Information

Primary practice address
24 Joliet St Dyer IN 46311-1705
Phone: (219) 865-2141
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01076100A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036138817 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 01076100A Indiana

Profile Details

NPI number 1598027153
LBN Legal business name Frederick, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2012
Last updated Mar 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598027153 NPPES
Indiana MEDICAID 201338270
Indiana Other F400244803

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