MEDICARE: DR. ERIC BERNARD FREEMAN M.D.

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	208000000X	Pediatrics Physician	0101238680	VA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578577086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC BERNARD FREEMAN M.D.

Provider Business Mailing Address
First Line	:	9323 MIDLOTHIAN TPKE
Second Line	:	SUITE E
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-212-1144
Fax Number	:	804-320-3681

Provider Business Practice Location Address
First Line	:	9323 MIDLOTHIAN TPKE
Second Line	:	SUITE E
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-212-1144
Fax Number	:	804-320-3681

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	08/12/2013

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