Healthcare Provider Details

I. General information

NPI: 1164415477
Provider Name (Legal Business Name): ALLISON L FREEMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLISON L REDFEARN M.D

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1459 JOHNSTON WILLIS DR
NORTH CHESTERFIELD VA
23235-4730
US

IV. Provider business mailing address

1459 JOHNSTON WILLIS DR
NORTH CHESTERFIELD VA
23235-4730
US

V. Phone/Fax

Practice location:
  • Phone: 804-794-9477
  • Fax: 804-794-1793
Mailing address:
  • Phone: 804-794-9477
  • Fax: 804-794-1793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number306604
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101053465
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number429162
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: