Healthcare Provider Details

I. General information

NPI: 1598506511
Provider Name (Legal Business Name): FREEDMENS MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 L ST SE
WASHINGTON DC
20003-3650
US

IV. Provider business mailing address

811 L ST SE
WASHINGTON DC
20003-3650
US

V. Phone/Fax

Practice location:
  • Phone: 202-683-4340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MCNEILL
Title or Position: CEO
Credential:
Phone: 910-988-8449