Provider Demographics
NPI:1821101312
Name:HARAD, FREDERIC TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:TODD
Last Name:HARAD
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 1:4755 OGLETOWN STANTON RD STE 1E20
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-5700
Mailing Address - Fax:302-733-5775
Practice Address - Street 1:4735 OGLETOWN STANTON ROAD
Practice Address - Street 2:SUITE 1E20
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-733-5700
Practice Address - Fax:302-733-5775
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00043462086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000568101Medicaid
000N55D21Medicare PIN
F86179Medicare UPIN