Provider Demographics
NPI:1053450932
Name:FREEMAN, BARRY M (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 N SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7005
Mailing Address - Country:US
Mailing Address - Phone:480-429-3400
Mailing Address - Fax:480-429-3468
Practice Address - Street 1:5225 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7005
Practice Address - Country:US
Practice Address - Phone:480-429-3400
Practice Address - Fax:480-429-3468
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ249348Medicaid
AZ118075Medicare PIN
AZ118076Medicare PIN
AZ118077Medicare PIN
AZ249348Medicaid
AZ249348Medicaid