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NPI Code Detail

MEDICARE: DR. JEREMY FREIWALD M.D.

MEDICARE: DR. JEREMY FREIWALD M.D.
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
1207R00000XInternal Medicine PhysicianMD468202PA

General Provider Information

NPI Number : 1538523097
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY FREIWALD M.D.
Provider Business Mailing Address
First Line : 1111 E END BLVD
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0026
Country : US
Telephone Number : 570-824-3521
Fax Number : 570-819-5173
Provider Business Practice Location Address
First Line : 1111 E END BLVD
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0026
Country : US
Telephone Number : 570-824-3521
Fax Number : 570-819-5173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2016
Last Update Date : 06/30/2020

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