Provider Demographics
NPI:1346315900
Name:FREEDMAN, DONIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DONIELLE
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
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: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:702-255-5653
Mailing Address - Fax:702-385-4723
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBS712YMedicare PIN
NVG17507Medicare UPIN