Provider Demographics
NPI:1760720460
Name:FREIBERG, WILLIAM EDWARD
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:FREIBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2893 STURGIS RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6607
Mailing Address - Country:US
Mailing Address - Phone:803-366-9099
Mailing Address - Fax:
Practice Address - Street 1:2602 J ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1643
Practice Address - Country:US
Practice Address - Phone:402-738-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5682183500000X
NE16999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist