Provider Demographics
NPI:1629125596
Name:ARNDT, FREDERICK VEDDER (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:VEDDER
Last Name:ARNDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:77 MACK WALTERS RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1789
Mailing Address - Country:US
Mailing Address - Phone:502-437-5161
Mailing Address - Fax:502-437-5163
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1789
Practice Address - Country:US
Practice Address - Phone:859-323-6047
Practice Address - Fax:859-257-3873
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41829207R00000X, 208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100069400Medicaid
KY000000731177OtherANTHEM
IN200911460Medicaid
KY50035432OtherPASSPORT
IN200911460Medicaid
KYK015341Medicare PIN