Provider Demographics
NPI:1164726329
Name:FREILICH, DREW (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:
Last Name:FREILICH
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 1:5673 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:STE 910
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1731
Mailing Address - Country:US
Mailing Address - Phone:404-255-3822
Mailing Address - Fax:404-255-0495
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD
Practice Address - Street 2:STE 910
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1731
Practice Address - Country:US
Practice Address - Phone:404-255-3822
Practice Address - Fax:404-255-0495
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL36566208800000X, 2088F0040X
GA074034208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003164375AMedicaid
GA003164375AMedicaid