Provider Demographics
NPI:1881653806
Name:SPECHT, FREDERICK W (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:SPECHT
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 1:789 WHITE POND DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320
Mailing Address - Country:US
Mailing Address - Phone:330-835-1934
Mailing Address - Fax:330-835-1937
Practice Address - Street 1:789 WHITE POND DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320
Practice Address - Country:US
Practice Address - Phone:330-835-1934
Practice Address - Fax:330-835-1937
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-4606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4205191OtherMEDICARE ID
OH0456653Medicaid
OH7206511OtherMEDICARE ID
OH7206511OtherMEDICARE ID