Healthcare Provider Details

I. General information

NPI: 1902489727
Provider Name (Legal Business Name): MATTHEW FREED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8021 2ND ST UNIT B
OSCODA MI
48750-2267
US

IV. Provider business mailing address

8021 2ND ST UNIT B
OSCODA MI
48750-2267
US

V. Phone/Fax

Practice location:
  • Phone: 734-210-1579
  • Fax:
Mailing address:
  • Phone: 734-210-1579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: