Provider Demographics
NPI:1487654968
Name:FREED, CLARENCE L (MD)
Entity type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:L
Last Name:FREED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:112 SCHOOL LANE
Mailing Address - Street 2:ATTN CLARENCE L FREED MD PC
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969
Mailing Address - Country:US
Mailing Address - Phone:215-721-6010
Mailing Address - Fax:215-721-6040
Practice Address - Street 1:112 SCHOOL LANE
Practice Address - Street 2:ATTN CLARENCE L FREED MD PC
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969
Practice Address - Country:US
Practice Address - Phone:215-721-6010
Practice Address - Fax:215-721-6040
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2023-04-12
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Provider Licenses
StateLicense IDTaxonomies
PAMD015219E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000171829OtherBS BS
PA000682666OtherBCBS LACHMARK
PA00098763810003Medicaid
50040715OtherCAPITAL BLUE CROSS GROUP
PA3000085OtherKEY CENTRAL
PA0516991000OtherKEY EAST & KEY GS GRP