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General NPI Number Information
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NPI Number | 1487654968
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Entity Type | Individual
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Provider Name | CLARENCE L FREED MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 112 SCHOOL LANE ATTN CLARENCE L FREED MD PC
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City | TELFORD
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State | PA
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Zip | 18969
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Country | US
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Telephone | 215-721-6010
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Fax | 215-721-6040
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Provider Business Mailing Address
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Address Line | 112 SCHOOL LANE ATTN CLARENCE L FREED MD PC
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City | TELFORD
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State | PA
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Zip | 18969
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Country | US
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Telephone | 215-721-6010
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Fax | 215-721-6040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD015219E
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License Number State | PA
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