MEDICARE: DONIELLE FREEDMAN, M.D. LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1093012874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONIELLE FREEDMAN, M.D. LTD

Provider Business Mailing Address
First Line	:	PO BOX 370644
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89137-0644
Country	:	US
Telephone Number	:	702-360-6003
Fax Number	:	702-360-6006

Provider Business Practice Location Address
First Line	:	7336 W POST RD STE 109
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-6647
Country	:	US
Telephone Number	:	702-360-6003
Fax Number	:	702-360-6006

Authorized Official
Title or Position	:	CREDENTIALER
Name	:	SANDRA FRIDAY
Credential	:
Telephone Number	:	702-800-8988

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	03/23/2023

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