Provider Demographics
NPI:1922557438
Name:ERDTMANN, FREDERICK JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JAMES
Last Name:ERDTMANN
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 1:490 M ST SW
Mailing Address - Street 2:APT 210W
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2612
Mailing Address - Country:US
Mailing Address - Phone:202-488-3316
Mailing Address - Fax:
Practice Address - Street 1:490 M ST SW
Practice Address - Street 2:APT 210W
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2612
Practice Address - Country:US
Practice Address - Phone:202-488-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012594E2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine