Provider Demographics
NPI:1093012874
Name:DONIELLE FREEDMAN, M.D. LTD
Entity Type:Organization
Organization Name:DONIELLE FREEDMAN, M.D. LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-800-8988
Mailing Address - Street 1:PO BOX 370644
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0644
Mailing Address - Country:US
Mailing Address - Phone:702-360-6003
Mailing Address - Fax:702-360-6006
Practice Address - Street 1:7336 W POST RD STE 109
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-6647
Practice Address - Country:US
Practice Address - Phone:702-360-6003
Practice Address - Fax:702-360-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 363A00000X, 363L00000X
NV7324261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty