Organization Name: | LEWIS H. FREED DPM PC |
NPI Number: | 1003987033 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEWIS H FREED (OWNER/PROVIDER) |
Mailing Address: | 6116 E. Arbor Ave Suite 118 Mesa |
State: | AZ US |
Postal Code: | 85206 |
Phone Number: | 4809241552 |
Fax Number: | 4808308417 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 03/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |