Healthcare Provider Details

I. General information

NPI: 1669446936
Provider Name (Legal Business Name): STEVEN A FREEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CUMBERLAND PARKWAY KAISER PERMANENTE CUMBERLAND MEDICAL OFFICE
ATLANTA GA
30339
US

IV. Provider business mailing address

3495 PIEDMONT ROAD NE NINE PIEDMONT CENTER
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 404-365-0966
  • Fax: 770-962-5056
Mailing address:
  • Phone: 404-364-7070
  • Fax: 770-962-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number026855
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: