Provider Demographics
NPI:1154995496
Name:FREIJ, JOUDEH BISHARA (MD)
Entity type:Individual
Prefix:
First Name:JOUDEH
Middle Name:BISHARA
Last Name:FREIJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2301 RESEARCH BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6544
Mailing Address - Country:US
Mailing Address - Phone:301-990-0137
Mailing Address - Fax:301-990-0471
Practice Address - Street 1:2301 RESEARCH BLVD STE 115
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6544
Practice Address - Country:US
Practice Address - Phone:301-990-1664
Practice Address - Fax:301-990-0471
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0101403208000000X
MI4351047417APP21390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics