Provider Demographics
NPI:1063077840
Name:MICHAEL A FREEDMAN D.O. P.C.
Entity type:Organization
Organization Name:MICHAEL A FREEDMAN D.O. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MORAN
Authorized Official - Last Name:PARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-479-7308
Mailing Address - Street 1:14600 KING RD STE D
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7952
Mailing Address - Country:US
Mailing Address - Phone:734-479-7310
Mailing Address - Fax:734-479-7307
Practice Address - Street 1:14600 KING RD STE D
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7952
Practice Address - Country:US
Practice Address - Phone:734-479-7310
Practice Address - Fax:734-479-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty