Provider Demographics
NPI:1487698122
Name:HOWARD, FRED M (MD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:M
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3232
Mailing Address - Fax:585-273-3359
Practice Address - Street 1:500 RED CREEK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4284
Practice Address - Country:US
Practice Address - Phone:585-487-3420
Practice Address - Fax:585-334-1264
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-08-26
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Provider Licenses
StateLicense IDTaxonomies
NY185405207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01262968Medicaid
NY01262968Medicaid
NYCC1757Medicare ID - Type Unspecified
NYJ400001813Medicare PIN