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1922040955
FREDERICK G DOUGLAS
EASLEY, SC
NPI
1922040955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: SC 5691)
Enumeration Date
2006-06-12
Last Update Date
2010-02-10
Business Address
-- FREDERICK G DOUGLAS MD
106 JOHN STREET
EASLEY, SC 29640-1415
Phone number: 864-859-2220
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Mailing Address
-- FREDERICK G DOUGLAS MD
PO BOX 2089
EASLEY, SC 29641-2089
Phone number: 864-855-5104
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