MEDICARE: DR. MICHAEL ANDREW FREEDMAN DO

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	5101024549	MI

General Provider Information

NPI Number	:	1851390066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANDREW FREEDMAN DO

Provider Business Mailing Address
First Line	:	14600 KING RD STE D
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7952
Country	:	US
Telephone Number	:	734-479-7310
Fax Number	:	734-479-7307

Provider Business Practice Location Address
First Line	:	14600 KING RD STE D
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7952
Country	:	US
Telephone Number	:	734-479-7310
Fax Number	:	734-479-7307

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	12/03/2019

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