Provider Demographics
NPI:1619941911
Name:WORK, FREDERICK TAYLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:TAYLOR
Last Name:WORK
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 1:1 BALTIMORE PL NW
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2116
Mailing Address - Country:US
Mailing Address - Phone:404-885-9675
Mailing Address - Fax:404-875-4017
Practice Address - Street 1:1 BALTIMORE PL NW
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2116
Practice Address - Country:US
Practice Address - Phone:404-885-9675
Practice Address - Fax:404-875-4017
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040593208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000685352HMedicaid
24BCBRFMedicare PIN
GAG-1935Medicare UPIN