Provider Demographics
NPI:1861450017
Name:FREIBERG ORTHOPAEDICS & SPORTS MEDICINE
Entity Type:Organization
Organization Name:FREIBERG ORTHOPAEDICS & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWSON
Authorized Official - Last Name:SWANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-221-5500
Mailing Address - Street 1:8250 KENWOOD CROSSING WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3668
Mailing Address - Country:US
Mailing Address - Phone:513-221-5500
Mailing Address - Fax:513-221-1962
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-221-5500
Practice Address - Fax:513-221-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-065879207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0686315Medicaid
OH9923326Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER