Frederick A Oldenburg Jr., MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

009401 Issued in ME

Practice address

417 State St
Ste 400
Bangor, ME 04401-6690

Phone

(207) 942-6096

Fax

(207) 973-8857

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Penobscot Respiratory

  • Pulmonary Disease Physician
  • Bangor, ME
  • NPI 1710925201
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1083662571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 400",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016690",
            "telephone_number": "207-973-8852",
            "fax_number": "207-973-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 400",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016690",
            "telephone_number": "207-942-6096",
            "fax_number": "207-973-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDENBURG",
        "first_name": "FREDERICK",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ME",
            "license": "009401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000559",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320260099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110046889",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ohi
• Ohi
• Ohi
• Ohi
• Isidore Chimezie Okere, MD
• Frederick Parke Oldenburg, M.D.
• Alston Wayne Oliver, PH.D., LCPC
• Alyssa Paige Oliver
• Lisa Marie Oliver, LCPC-C
• Shawna Marie Oliver

• Pulmonary Disease Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Pulmonary Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.