Provider Demographics
NPI:1063494060
Name:FRESCHI, JOSEPH EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:FRESCHI
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 1:227 SANDY SPRINGS PL
Mailing Address - Street 2:SUITE D #145
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-295-5473
Mailing Address - Fax:404-847-0991
Practice Address - Street 1:700 MOUNTAIN CREEK TRCE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3530
Practice Address - Country:US
Practice Address - Phone:404-295-5473
Practice Address - Fax:404-847-0991
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018221174400000X
GA182212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D29502Medicare UPIN
GA13BDDDJMedicare PIN
GAD29502Medicare UPIN