Provider Demographics
NPI:1497080972
Name:HARRIS L FREEDMAN, DO, INC
Entity Type:Organization
Organization Name:HARRIS L FREEDMAN, DO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-477-9909
Mailing Address - Street 1:9775 TAYLOR MAY RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-2422
Mailing Address - Country:US
Mailing Address - Phone:440-477-9909
Mailing Address - Fax:440-975-1760
Practice Address - Street 1:9775 TAYLOR MAY RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-2422
Practice Address - Country:US
Practice Address - Phone:440-477-9909
Practice Address - Fax:440-975-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3143F207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0555153Medicaid
OH0555153Medicaid
OHHA0547754Medicare PIN