Provider Demographics
NPI:1831141506
Name:NELSEN-FREUND, EDWARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:M
Last Name:NELSEN-FREUND
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPT OF ORTHOPAEDIC SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-7410
Mailing Address - Fax:414-805-7499
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DEPT OF ORTHOPAEDIC SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-7410
Practice Address - Fax:414-805-7499
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI42326207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1831141506Medicaid
006906261NOtherHUMANA
WI1831141506Medicaid
H09364Medicare UPIN
WI076P73601Medicare PIN