Wallisch, Fredrick H

Wallisch, Fredrick H is an individual health care provider with primary practice located at 515 Read St , Evansville IN 47710-1739. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wallisch, Fredrick H can be contacted via phone (812) 450-3363.

Contact Information

Primary practice address
515 Read St Evansville IN 47710-1739
Fax: (812) 450-3071
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01059213A Indiana

Profile Details

NPI number 1528027950
LBN Legal business name Wallisch, Fredrick H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Sep 15th, 2014 - about 12 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 1528027950 NPPES
Indiana Other P00315732 RR MEDICARE
Indiana MEDICAID 200042820 RR MEDICARE

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