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NPI Code Detail

MEDICARE: MRS. SHELLEY L FREIMARK MD

MEDICARE: MRS. SHELLEY L FREIMARK MD
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
1208100000XPhysical Medicine & Rehabilitation Physician4301066173MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1250010895OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2SF066173OTHERMISTATE LICENSE #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
42507011161OTHERMIBLUE CROSS

General Provider Information

NPI Number : 1386641892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHELLEY L FREIMARK MD
Provider Business Mailing Address
First Line : 5500 ARMSTRONG RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49037-7314
Country : US
Telephone Number : 269-966-5600
Fax Number :
Provider Business Practice Location Address
First Line : 5500 ARMSTRONG RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49037-7314
Country : US
Telephone Number : 269-966-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 04/15/2020

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