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General NPI Number Information
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NPI Number | 1750544862
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Entity Type | Individual
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Provider Name | LAURA A FREEMAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 09/17/2022
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Provider Practice Location Address
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Address Line | 2955 XENIUM LN N STE 40
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City | PLYMOUTH
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State | MN
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Zip | 55441-2668
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Country | US
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Telephone | 763-559-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 CAMPUS DR STE 10
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City | PLYMOUTH
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State | MN
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Zip | 55441-2669
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Country | US
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Telephone | 763-559-2171
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 52220
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License Number State | MN
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