Provider Demographics
NPI:1225046063
Name:NEMER, FREDERIC D (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:D
Last Name:NEMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9201 WEST BROADWAY
Mailing Address - Street 2:SUITE 601
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445
Mailing Address - Country:US
Mailing Address - Phone:763-587-7900
Mailing Address - Fax:763-587-7989
Practice Address - Street 1:3366 OAKDALE AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-587-7900
Practice Address - Fax:763-587-7989
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2014-07-31
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Provider Licenses
StateLicense IDTaxonomies
MN19732208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN257888300Medicaid
MN257888300Medicaid
MNA96195Medicare UPIN