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OIG exclusion detail

MARK FREDERICK

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
0000000000
Name
MARK ALLEN FREDERICK
Address
3343 WILLIAMSBURG DR, LINCOLN, NE, 68516
Specialty
OWNER/OPERATOR
Exclusion type
1128b7
Exclusion date
20090126
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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