Provider Demographics
NPI:1003914730
Name:FREE, MADELINE L (MD)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:L
Last Name:FREE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1463 I94 BUSINESS LOOP E STE 1
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-6434
Mailing Address - Country:US
Mailing Address - Phone:701-227-7500
Mailing Address - Fax:701-227-7575
Practice Address - Street 1:1463 I94 BUSINESS LOOP E STE 1
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-6434
Practice Address - Country:US
Practice Address - Phone:701-227-7500
Practice Address - Fax:701-227-7575
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ND70792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18626Medicaid
NDF96913Medicare UPIN
ND21371Medicare PIN