MEDICARE: DR. GREGORY H FREITAG 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	207Q00000X	Family Medicine Physician	0101235613	VA

General Provider Information

NPI Number	:	1679545867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY H FREITAG MD

Provider Business Mailing Address
First Line	:	3259 CATLIN AVE
Second Line	:
City	:	QUANTICO
State	:	VA
Zip	:	22134
Country	:	US
Telephone Number	:	703-784-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	BHC WASHINGTON NAVY YARD
Second Line	:	915 N STREET SE
City	:	WASHINGTON
State	:	DC
Zip	:	20374
Country	:	US
Telephone Number	:	202-433-3294
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	06/11/2024

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