Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT193051 | PA |
Y | 2080P0210X | Pediatric Nephrologist | MD442312 | PA |
NPI | 1598927360 |
---|---|
Provider Name | Dr. Michael Aloysius Freeman |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 08/07/2014 |