Healthcare Provider Details

I. General information

NPI: 1154811461
Provider Name (Legal Business Name): P DAVID FREEMAN MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7480 LONGLEY LN
RENO NV
89511-1228
US

IV. Provider business mailing address

7480 LONGLEY LN
RENO NV
89511-1228
US

V. Phone/Fax

Practice location:
  • Phone: 775-451-7268
  • Fax: 775-451-7270
Mailing address:
  • Phone: 775-451-7268
  • Fax: 775-451-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER DAVID FREEMAN
Title or Position: OWNER / PHYSICIAN
Credential: MD
Phone: 775-451-7268