Provider Demographics
NPI:1184698870
Name:FREUND, FLORENCE MAISONNEUVE (PA-C)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:MAISONNEUVE
Last Name:FREUND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:
Other - Last Name:MCNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9252 STREAM VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10724 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3106
Practice Address - Country:US
Practice Address - Phone:410-997-5944
Practice Address - Fax:410-997-1720
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001152363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKQ58M597Medicare ID - Type Unspecified
DC018128P50Medicare ID - Type Unspecified
MDS644Medicare PIN
MDQ53590Medicare UPIN