Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | SC002174L | PA |
NPI | 1073552675 |
---|---|
Provider Name | Dr. Lee Michael Freeman |
First Address | New Britain, PA 18901-5052 |
Second Address | Doylestown, PA 18901-4870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 14/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0023148000 | KEYSTONE HEALTH PLAN EAST (01) | PA |
1033350 | KEYSTONE MERCY (01) | PA |
T29706 | (02) | PA |