Provider Demographics
NPI:1770631889
Name:FREED, CHRISTOPHER J (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:FREED
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4004 HALLGREN CT
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-7755
Mailing Address - Country:US
Mailing Address - Phone:612-518-9772
Mailing Address - Fax:952-466-3936
Practice Address - Street 1:1464 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2525
Practice Address - Country:US
Practice Address - Phone:952-466-3937
Practice Address - Fax:952-466-3936
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2627152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U82414Medicare UPIN
MN410001491Medicare ID - Type Unspecified