Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 7973 | MD |
Y | 213EG0000X | General Practice | 7973 | MD |
NPI | 1003136086 |
---|---|
Provider Name | Dr. Joel Howard Freedenberg |
First Address | Olney, MD 20832-1675 |
Second Address | Clarksville, MD 21029-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2010 |
Last Update Date | 02/06/2010 |