Provider Demographics
NPI:1619923976
Name:ARLOW, FREDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDA
Middle Name:L
Last Name:ARLOW
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 1:215 E MANSION ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1559
Mailing Address - Country:US
Mailing Address - Phone:269-789-0025
Mailing Address - Fax:269-789-0445
Practice Address - Street 1:215 E MANSION ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1559
Practice Address - Country:US
Practice Address - Phone:269-789-0025
Practice Address - Fax:269-789-0445
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043970207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104393238Medicaid
MI260A376690OtherBCBSM
MI104393238Medicaid