Marc K Frederick

NPI #1083189831 in Salt Lake City, Utah

Provider Information

NPI Number: 1083189831
Entity Type: Individual
Name: Marc K Frederick
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Oct 8, 2018
Last Updated: Oct 8, 2018

Practice Location

Address: 2216 S FOOTHILL DR APT 310G
City: Salt Lake City
State: Utah
ZIP Code: 84109-3998
Phone: (517) 420-8771

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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