MEDICARE: NATHAN FREED DO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	OS006031E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00025016	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	500525	OTHER	PA	COVENTRY HEALTH AMERICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1644822	OTHER	PA	HIGHMARK BLUE SHIELD
4	30027706	OTHER	PA	KMHP
5	3Y5980	OTHER	PA	HEALTH NET
6	1238538	OTHER	PW	UNITED HEALTHCARE
8	0003287701	OTHER	PA	AMERICHOICE
9	12844	OTHER	PA	BRAVO HEALTH
10	1029320	OTHER	PA	AETNA HMO
11	2319758000	OTHER	PA	INDEPENDENCE BLUE CROSS
12	5808048	OTHER	PA	AETNA PPO

General Provider Information

NPI Number	:	1285618850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN FREED DO

Provider Business Mailing Address
First Line	:	2301 E ALLEGHENY AVE
Second Line	:	1ST FLOOR
City	:	PHILA
State	:	PA
Zip	:	19134-4427
Country	:	US
Telephone Number	:	215-926-9022
Fax Number	:	215-926-3888

Provider Business Practice Location Address
First Line	:	2301 E ALLEGHENY AVE
Second Line	:	MADEL PAVILION 1ST FL
City	:	PHILA
State	:	PA
Zip	:	19134-4427
Country	:	US
Telephone Number	:	215-936-3880
Fax Number	:	215-926-3888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	01/25/2011

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Directions to “ NATHAN FREED DO” Practice Location

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