Fricke, Thaddeus Carl

Fricke, Thaddeus Carl is an individual health care provider with primary practice located at 200 Patewood Dr Suite C100, Greenville SC 29615-3593. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fricke, Thaddeus Carl can be contacted via phone (864) 454-7422.

Contact Information

Primary practice address
200 Patewood Dr Suite C100 Greenville SC 29615-3593
Phone: (864) 454-7422
Fax: (864) 454-8265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 915 South Carolina

Profile Details

NPI number 1154372456
LBN Legal business name Fricke, Thaddeus Carl
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Aug 2nd, 2013 - 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 1154372456 NPPES
South Carolina Other P00847276 RAILROAD MEDICARE
South Carolina MEDICAID 0449PA RAILROAD MEDICARE

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