Healthcare Provider Details

I. General information

NPI: 1659483444
Provider Name (Legal Business Name): SHELDON JAY FREEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 N TOWN CENTER DR STE 308
LAS VEGAS NV
89144-0517
US

IV. Provider business mailing address

653 N TOWN CENTER DR STE 308
LAS VEGAS NV
89144-0517
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-0282
  • Fax: 702-369-6981
Mailing address:
  • Phone: 702-732-0282
  • Fax: 702-369-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number4828
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: