Healthcare Provider Details

I. General information

NPI: 1003987033
Provider Name (Legal Business Name): LEWIS H. FREED DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6116 E. ARBOR AVE SUITE 118
MESA AZ
85206
US

IV. Provider business mailing address

PO BOX 504691
SAINT LOUIS MO
63150-4691
US

V. Phone/Fax

Practice location:
  • Phone: 480-924-1552
  • Fax: 480-830-8417
Mailing address:
  • Phone: 480-924-1552
  • Fax: 480-830-8417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: LEWIS H FREED
Title or Position: OWNER/PROVIDER
Credential: DPM
Phone: 480-924-1552