Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD21583 | OR |
NPI | 1073611687 |
---|---|
Provider Name | Dr. Breton Charles Freitag |
First Address | Portland, OR 97227 |
Second Address | Portland, OR 97227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286457 | (05) | OR |