Healthcare Provider Details

I. General information

NPI: 1043288178
Provider Name (Legal Business Name): PAUL B FREEMAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E NORTH AVE SUITE 116
PITTSBURGH PA
15212-4746
US

IV. Provider business mailing address

420 E NORTH AVE SUITE 116
PITTSBURGH PA
15212-4746
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-6301
  • Fax:
Mailing address:
  • Phone: 412-359-6301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOEG000609
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: