Provider Demographics
NPI:1063712032
Name:FREEMAN, MICHAEL ALBERT (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALBERT
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 S. RIVERBEND
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657
Mailing Address - Country:US
Mailing Address - Phone:559-875-7605
Mailing Address - Fax:
Practice Address - Street 1:1161 S. RIVERBEND
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-9518
Practice Address - Country:US
Practice Address - Phone:559-875-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-233952086H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative Medicine