Provider Demographics
NPI:1124007752
Name:FINGERHUT, FREDRICK D (MD)
Entity Type:Individual
Prefix:
First Name:FREDRICK
Middle Name:D
Last Name:FINGERHUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 E CAMELBACK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3911
Mailing Address - Country:US
Mailing Address - Phone:602-422-9012
Mailing Address - Fax:
Practice Address - Street 1:10240 W INDIAN SCHOOL RD
Practice Address - Street 2:BUILDING 2 STE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5904
Practice Address - Country:US
Practice Address - Phone:623-846-7558
Practice Address - Fax:623-846-1674
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6294207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCJDJ02Medicare PIN
AZE00209Medicare UPIN