Provider Demographics
NPI:1821393935
Name:POMEROY, FRED WILLIS (DVM, ND)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:WILLIS
Last Name:POMEROY
Suffix:
Gender:M
Credentials:DVM, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 7TH ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2302
Mailing Address - Country:US
Mailing Address - Phone:651-224-4815
Mailing Address - Fax:
Practice Address - Street 1:185 7TH ST E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2302
Practice Address - Country:US
Practice Address - Phone:651-224-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01674174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian