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Contact Information

NICHOLAS W FREDERICKSON, MD
901 PATIENTS FIRST DRIVE SUITE 3300
WASHINGTON, MO63090
 Phone: 636-239-7344
 Fax: 636-239-9436
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for NICHOLAS W FREDERICKSON · (Male)

NPI # 1154640225
Status Active
Credentials MD
Entity Individual
Enumeration date 05/27/2010
Last updated 01/14/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IA License # R-8906
  • MO License # 2016012330
Hospital affiliation(s)
  • MERCY HOSPITAL WASHINGTON - (Acute Care)
    901 EAST 5TH STREET
    WASHINGTON, MO 63090
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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