Provider Demographics
NPI:1467989632
Name:GARLAND, FREDERICK JAMES (DPM)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:JAMES
Last Name:GARLAND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 WINTERCREEPER DR
Mailing Address - Street 2:
Mailing Address - City:LONGS
Mailing Address - State:SC
Mailing Address - Zip Code:29568-9229
Mailing Address - Country:US
Mailing Address - Phone:304-639-2727
Mailing Address - Fax:
Practice Address - Street 1:7050 HIGHWAY 90 UNIT C
Practice Address - Street 2:
Practice Address - City:LONGS
Practice Address - State:SC
Practice Address - Zip Code:29568-6232
Practice Address - Country:US
Practice Address - Phone:843-653-0768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC706213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist