Provider Demographics
NPI:1558348540
Name:MARGOLIN, FRED G (DO)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:G
Last Name:MARGOLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2773 DEER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2112
Mailing Address - Country:US
Mailing Address - Phone:515-254-9090
Mailing Address - Fax:515-276-4244
Practice Address - Street 1:2773 DEER CREEK TRL
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50323-2112
Practice Address - Country:US
Practice Address - Phone:515-254-9090
Practice Address - Fax:515-276-4244
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA013172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology