Provider Demographics
NPI:1063438521
Name:THUM, FREDERICK LORENZ III (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:LORENZ
Last Name:THUM
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1149
Mailing Address - Street 2:MOUNT SINAI MEDICAL CTR, DEPT OF EMERGENCY MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-241-6639
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L LEVY PL # 1149
Practice Address - Street 2:MOUNT SINAI MEDICAL CTR, DEPT OF EMERGENCY MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-241-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2020-08-24
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA227651207P00000X
NY229567207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine