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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK R FREDERIKSEN, R.PH.

Active

MARK R FREDERIKSEN, R.PH. is a Pharmacist healthcare provider located in PORTAGE, Wisconsin. NPI 1043565526 is currently active in the NPPES registry. Verify at CMS.

Pharmacist · PORTAGE, WI

Registration Details

NPI Number
1043565526
Provider Type
Individual
Gender
Male
NPI Issued
Jul 19, 2012 (14.048731574804 yrs)
Last Updated
Jul 19, 2012
License
10269 (WI)

Practice Information

Address
2935 NEW PINERY RD
PORTAGE, WI, 539019226
Browse WI providers · Browse ZIP 53901
Phone
6087423886
Primary Specialty
Pharmacist
183500000X

Other Pharmacist Providers in PORTAGE, WI

Name Credential NPI
JEFFREY ROBERT HEBL R.PH 1770868846
DAVID RICHARD JACOBSON PHARMD 1194000232
MR. RANDY LEE GRIFFITHS PHARM D. 1356626444
TIFFANIE MARION WRIGHT PHARMD 1154692291
GREGORY WEAVER RPH 1891051744
MRS. KASHEA LYFOUNG PHARM.D. 1538425525
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.