Provider Demographics
NPI:1558426361
Name:FREILICH, HOWARD S (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:S
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 1:1010 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-3447
Mailing Address - Country:US
Mailing Address - Phone:843-645-8220
Mailing Address - Fax:843-645-8221
Practice Address - Street 1:1010 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-3447
Practice Address - Country:US
Practice Address - Phone:843-645-8220
Practice Address - Fax:843-645-8221
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36340207RG0100X
PAMD026445E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011077810002Medicaid
C33221Medicare UPIN
C33221Medicare UPIN