Healthcare Provider Details

I. General information

NPI: 1578562013
Provider Name (Legal Business Name): FREELAND GERARD OLIVERIO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COLLIER DR
DOYLESTOWN OH
44230-9757
US

IV. Provider business mailing address

400 COLLIER DR PO BOX 38
DOYLESTOWN OH
44230-9757
US

V. Phone/Fax

Practice location:
  • Phone: 330-658-2081
  • Fax: 330-658-4897
Mailing address:
  • Phone: 330-658-2081
  • Fax: 330-658-4897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34003750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: