Provider Demographics
NPI:1649274036
Name:FREEDMAN, WILLIAM BERNIS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BERNIS
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 RYE HOLLOW LANE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-960-5288
Mailing Address - Fax:434-293-4265
Practice Address - Street 1:3225 RYE HOLLOW LANE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-960-5288
Practice Address - Fax:434-293-4265
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2020-09-18
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
VA0101023877207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA247323OtherANTHEM
VAC10061OtherMEDICARE GROUP PIN
VA456180OtherSOUTHERN HEALTH
VA1649274036Medicaid
VAP00384294OtherRAILROAD MEDICARE
VA060055256Medicare PIN
VAA43153Medicare UPIN
VA247323OtherANTHEM
VA00X295C02Medicare PIN