Provider Demographics
NPI:1649346032
Name:FREEMAN, BRIDGET (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 TIERRA VERDE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-4527
Mailing Address - Country:US
Mailing Address - Phone:715-587-4904
Mailing Address - Fax:
Practice Address - Street 1:HEMOPHILIA OUTREACH CENTER
Practice Address - Street 2:2060 BELLEVUE ST
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311
Practice Address - Country:US
Practice Address - Phone:920-965-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEEL151023208000000X
MI4301091783208000000X
NHLT3572208000000X
FLME532992080P0207X, 2080P0207X
MT42713208000000X
WI684022080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055906700Medicaid
WI100069604Medicaid
FL12969OtherBLUE CROSS
FLME53299OtherLICENSE
FL510438973OtherEIN
FL12969Medicare ID - Type Unspecified
FL055906700Medicaid