Frederiksen, Marilynn E

Frederiksen, Marilynn E is an individual health care provider with primary practice located at 945 N 12Th St , Milwaukee WI 53233-1305. She recently has only one registered license in Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine, which is considered as her primary health care specialty. Frederiksen, Marilynn E can be contacted via phone (414) 219-7956.

Contact Information

Primary practice address
945 N 12Th St Milwaukee WI 53233-1305
Phone: (414) 219-7956
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 36058725 Illinois
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 68138 Wisconsin

Profile Details

NPI number 1811996796
LBN Legal business name Frederiksen, Marilynn E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Sep 4th, 2019 - 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 1811996796 NPPES
Illinois Other 1627904 BLUE CROSS/BLUE SHIELD NO
Illinois MEDICAID 100071887 BLUE CROSS/BLUE SHIELD NO

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