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General NPI Number Information
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NPI Number | 1689793077
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Entity Type | Individual
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Provider Name | ELSIE J FREEMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MAIN DHHS 11 STATE HOUSE STATION
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City | AUGUSTA
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State | ME
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Zip | 04333-0001
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Country | US
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Telephone | 207-287-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 123 KIMBALLTOWN RD
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City | TREVETT
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State | ME
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Zip | 04571-3134
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Country | US
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Telephone | 207-287-4262
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 33270
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License Number State | MA
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