MEDICARE: DR. TERRY ALLAN FREIBERG DPM

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	213E00000X	Podiatrist	PD061R	LA

General Provider Information

NPI Number	:	1619977022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY ALLAN FREIBERG DPM

Provider Business Mailing Address
First Line	:	2921 DAVID DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-4515
Country	:	US
Telephone Number	:	504-888-3668
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 DAVID DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003
Country	:	US
Telephone Number	:	504-888-3668
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/01/2019

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