Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A67545 | CA |
N | 111NI0900X | Internist | A67545 | CA |
N | 207RP1001X | Pulmonary Disease | A67545 | CA |
NPI | 1013931211 |
---|---|
Provider Name | Michelle Monique Freemer |
First Address | San Francisco, CA 94120-7464 |
Second Address | San Francisco, CA 94110-3518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A675450 | (05) | CA |
H33479 | (02) |