Provider Demographics
NPI:1336115468
Name:FREEDMAN, BRUCE E (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:E
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10250 N 92ND ST STE 307
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4520
Mailing Address - Country:US
Mailing Address - Phone:480-941-0866
Mailing Address - Fax:480-423-1375
Practice Address - Street 1:10250 N 92ND ST STE 307
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4520
Practice Address - Country:US
Practice Address - Phone:480-941-0866
Practice Address - Fax:480-423-1375
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ17665208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1336115468OtherNPI
AZ860695329OtherTAX ID NUMBER
AZ860695329OtherTAX ID NUMBER