Provider Demographics
NPI:1285618850
Name:FREED, NATHAN (DO)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:FREED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2301 E ALLEGHENY AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4427
Mailing Address - Country:US
Mailing Address - Phone:215-926-9022
Mailing Address - Fax:215-926-3888
Practice Address - Street 1:2301 E ALLEGHENY AVE
Practice Address - Street 2:MADEL PAVILION 1ST FL
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19134-4427
Practice Address - Country:US
Practice Address - Phone:215-936-3880
Practice Address - Fax:215-926-3888
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006031E207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA500525OtherCOVENTRY HEALTH AMERICA
PA000868000Medicaid
PA1644822OtherHIGHMARK BLUE SHIELD
PA30027706OtherKMHP
PA3Y5980OtherHEALTH NET
PW1238538OtherUNITED HEALTHCARE
PAP00025016OtherRR MEDICARE
PA0003287701OtherAMERICHOICE
PA12844OtherBRAVO HEALTH
PA1029320OtherAETNA HMO
PA2319758000OtherINDEPENDENCE BLUE CROSS
PA5808048OtherAETNA PPO
PAP00025016OtherRR MEDICARE
C52848Medicare UPIN