Provider Demographics
NPI:1073552675
Name:FREEMAN, LEE MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:MICHAEL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MOHEGAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5052
Mailing Address - Country:US
Mailing Address - Phone:215-348-4865
Mailing Address - Fax:215-348-1416
Practice Address - Street 1:301 S MAIN ST, STE 3E
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4870
Practice Address - Country:US
Practice Address - Phone:215-348-3338
Practice Address - Fax:215-348-1416
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002174L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0023148000OtherKEYSTONE HEALTH PLAN EAST
PA1033350OtherKEYSTONE MERCY
PAT29706Medicare UPIN
PA153751Medicare ID - Type Unspecified