3025 W CHERRY LANE
MERIDIAN, ID 83642 US PECOS Enrolled
Overview
Fred W Fender is a Family Medicine Physician in the MERIDIAN area. Fred W Fender primary office location is at 3025 W CHERRY LANE and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1558300491 and the information was updated approximately 8 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| M4500 | ID |
| Type/Issuer | Identifier | State |
|---|---|---|
| MEDICAID | 002576400 | ID |
| Taxonomy | State | Primary? |
|---|---|---|
| Family Medicine Physician - Taxonomy Code 207Q00000X | ID | Y |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | |
| PECOS Individual PAC ID: | |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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