Provider Demographics
NPI:1902046121
Name:CANTOR, FREDRIC K (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:K
Last Name:CANTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7200 LONGWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2122
Mailing Address - Country:US
Mailing Address - Phone:240-498-8310
Mailing Address - Fax:301-365-6609
Practice Address - Street 1:7200 LONGWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2122
Practice Address - Country:US
Practice Address - Phone:240-498-8310
Practice Address - Fax:301-365-6609
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD132732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology