Provider Demographics
NPI:1639284821
Name:DEBOE, FREDERICK M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:M
Last Name:DEBOE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-647-6326
Mailing Address - Fax:414-671-8860
Practice Address - Street 1:1575 N RIVERCENTER DR
Practice Address - Street 2:#124
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3965
Practice Address - Country:US
Practice Address - Phone:414-283-8444
Practice Address - Fax:414-283-8450
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2021-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01032345A207Q00000X
WI23016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine