Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 042836 | GA |
Y | 207RC0000X | Internist - Cardiovascular Disease | ME 54304 | FL |
NPI | 1023013661 |
---|---|
Provider Name | Frank Edward Gredler |
First Address | Tallahassee, FL 32308-4646 |
Second Address | Tallahassee, FL 32308-4646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 09/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00000 | BLUE CROSS BLUE SHIELD (01) | GA |
000659062A | (05) | GA |
009979020 | (05) | AL |
01106 | UNIVERSAL HEALTH CARE (01) | FL |
04619 | BLUE CROSS BLUE SHIELD (01) | FL |
049104700 | (05) | FL |
B37396 | (02) |