MEDICARE: EDUARDO AUGUSTO FONSECA FREITAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	24990	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437248994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDUARDO AUGUSTO FONSECA FREITAS MD

Provider Business Mailing Address
First Line	:	611 W FRANCIS ST
Second Line	:	SUITE 200
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-0620
Country	:	US
Telephone Number	:	308-696-8280
Fax Number	:	308-696-8279

Provider Business Practice Location Address
First Line	:	611 W FRANCIS ST
Second Line	:	SUITE 200
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-0620
Country	:	US
Telephone Number	:	308-696-8280
Fax Number	:	308-696-8279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/13/2012

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Directions to “ EDUARDO AUGUSTO FONSECA FREITAS MD” Practice Location

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