Provider Demographics
NPI:1619977022
Name:FREIBERG, TERRY ALLAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALLAN
Last Name:FREIBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:T.
Other - Middle Name:ALLAN
Other - Last Name:FREIBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2921 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-4515
Mailing Address - Country:US
Mailing Address - Phone:504-888-3668
Mailing Address - Fax:
Practice Address - Street 1:2921 DAVID DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003
Practice Address - Country:US
Practice Address - Phone:504-888-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD061R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist