MEDICARE: ELSIE J 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	2084P0800X	Psychiatry Physician	33270	MA

General Provider Information

NPI Number	:	1689793077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSIE J FREEMAN M.D.

Provider Business Mailing Address
First Line	:	123 KIMBALLTOWN RD
Second Line	:
City	:	TREVETT
State	:	ME
Zip	:	04571-3134
Country	:	US
Telephone Number	:	207-287-4262
Fax Number	:

Provider Business Practice Location Address
First Line	:	MAIN DHHS
Second Line	:	11 STATE HOUSE STATION
City	:	AUGUSTA
State	:	ME
Zip	:	04333-0001
Country	:	US
Telephone Number	:	207-287-4262
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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