1437296985 NPI number — DANIEL M. FREED, PLLC

Table of content: (NPI 1437296985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437296985 NPI number — DANIEL M. FREED, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL M. FREED, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437296985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
393 LONGRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTEREY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24465-2347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-474-2785
Provider Business Mailing Address Fax Number:
540-474-2785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3292 SAM SNEAD H
Provider Second Line Business Practice Location Address:
DRAWER 1070
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24445-1070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-839-7083
Provider Business Practice Location Address Fax Number:
540-839-7090
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FREED
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
540-839-7083

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0101229131 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1730157066 . This is a "PERSONAL PROVIDER NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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