Provider Demographics
NPI:1578577086
Name:FREEMAN, ERIC BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BERNARD
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9323 MIDLOTHIAN TPKE
Mailing Address - Street 2:SUITE E
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4942
Mailing Address - Country:US
Mailing Address - Phone:804-212-1144
Mailing Address - Fax:804-320-3681
Practice Address - Street 1:9323 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE E
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4942
Practice Address - Country:US
Practice Address - Phone:804-212-1144
Practice Address - Fax:804-320-3681
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238680208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1578577086Medicaid
VA010213720Medicaid