MEDICARE: DR. MELVIN IRWIN FREEMAN 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
1	207W00000X	Ophthalmology Physician	MD00010669	WA

General Provider Information

NPI Number	:	1588793939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN IRWIN FREEMAN M.D.

Provider Business Mailing Address
First Line	:	4625 92ND AVE NE
Second Line	:
City	:	YARROW POINT
State	:	WA
Zip	:	98004-1336
Country	:	US
Telephone Number	:	425-454-4868
Fax Number	:	425-454-5449

Provider Business Practice Location Address
First Line	:	4625 92ND AVE NE
Second Line	:
City	:	YARROW POINT
State	:	WA
Zip	:	98004-1336
Country	:	US
Telephone Number	:	425-454-4868
Fax Number	:	425-454-5449

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

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	07/08/2007

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