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General NPI Number Information
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NPI Number | 1922103639
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Entity Type | Individual
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Provider Name | LAWRENCE E FREEDBERG MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 LIGONIER ST
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City | LATROBE
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State | PA
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Zip | 15650-1426
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Country | US
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Telephone | 724-539-9736
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Fax | 724-539-2836
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Provider Business Mailing Address
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Address Line | 600 LIGONIER ST
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City | LATROBE
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State | PA
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Zip | 15650-1426
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Country | US
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Telephone | 724-539-9736
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Fax | 724-539-2836
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD017654E
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License Number State | PA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 0638412
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 300589
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | UPMC
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Identifier #3
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Identifier Code | 1002238
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | GATEWAY
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Identifier #4
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Identifier Code | 088162
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | HIGHMARK BLUE SHIELD
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 0638412
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 088162
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | HIGHMARK BLUE SHIELD
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Identifier #3
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Identifier Code | 1002238
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | GATEWAY
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Identifier #4
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Identifier Code | 300589
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | UPMC
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