Provider Demographics
NPI:1043494974
Name:FREEDMAN, STUART IRWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:IRWIN
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 RIDGEMOOR PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5549
Mailing Address - Country:US
Mailing Address - Phone:757-725-0612
Mailing Address - Fax:
Practice Address - Street 1:13817 VILLAGE MILL DR
Practice Address - Street 2:STE K
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4378
Practice Address - Country:US
Practice Address - Phone:757-725-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU53701Medicare UPIN
VA350000886Medicare PIN