Healthcare Provider Details

I. General information

NPI: 1598086407
Provider Name (Legal Business Name): BETH E FREEDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N DUKE ST
LANCASTER PA
17602
US

IV. Provider business mailing address

555 N DUKE ST
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-4950
  • Fax: 717-544-5964
Mailing address:
  • Phone: 717-544-4950
  • Fax: 717-544-5964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD448266
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: