Frederick T Fedorowicz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001212 Issued in MI

Practice address

600 E Lafayette Blvd
J426
Detroit, MI 48226-2927

Phone

(313) 225-8173

Fax

(313) 225-0956

NPI assigned

Nov 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306918990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W NOBLE AVE",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622740",
            "telephone_number": "734-243-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E LAFAYETTE BLVD",
            "address_2": "J426",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482262927",
            "telephone_number": "313-225-8173",
            "fax_number": "313-225-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOROWICZ",
        "first_name": "FREDERICK",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Fearn, CRNA
• Delores Featherstone
• Melissa February, MD
• Odeta Fecani, PHARM.D.
• Peter J. Feczko, M.D.
• Mackenzie Christine Fee
• Feeding Ninos, LLC
• Nicholas Feeley, MSW
• Karly Bryan Feeman, AA
• Taylor Fegan, MD

• Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.