Provider Demographics
NPI:1821195090
Name:ASARE, FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:ASARE
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 1:504 OWEN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3417
Mailing Address - Country:US
Mailing Address - Phone:910-221-3030
Mailing Address - Fax:910-221-3039
Practice Address - Street 1:504 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3417
Practice Address - Country:US
Practice Address - Phone:910-221-3030
Practice Address - Fax:910-221-3039
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905408Medicaid
NCPENDINGMedicare ID - Type UnspecifiedPROVIDER NUMBER
NC5905408Medicaid