Provider Demographics
NPI:1992877989
Name:LUDWIG, FREDERICK E II (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:E
Last Name:LUDWIG
Suffix:II
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 1:550 OSBORN BLVD
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1899
Mailing Address - Country:US
Mailing Address - Phone:906-632-3753
Mailing Address - Fax:906-635-7872
Practice Address - Street 1:550 OSBORN BLVD
Practice Address - Street 2:SUITE 1006
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1899
Practice Address - Country:US
Practice Address - Phone:906-632-3753
Practice Address - Fax:906-635-7872
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010227693208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3491815Medicaid
MIA76002039Medicare ID - Type Unspecified
MIG80742Medicare UPIN