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Contact Information

SCOTT C FRIEDERSDORF, DPM
100 MEDICAL DR
HANNIBAL, MO63401-6877
 Phone: 573-231-3773
 Fax: 573-231-3828
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SCOTT C FRIEDERSDORF · (Male)

NPI # 1508845298
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 01/11/2006
Last updated 03/03/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2003009611
  • MO Medicaid 308463702
Hospital affiliation(s)
  • HANNIBAL REGIONAL HOSPITAL - (Acute Care)
    6000 HOSPITAL DR
    HANNIBAL, MO 63401
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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