Provider Demographics
NPI:1770147746
Name:FREUDENBERGER, DEVON CLEMONS (MD)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:CLEMONS
Last Name:FREUDENBERGER
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:VCUHS GME ADMINISTRATION
Mailing Address - Street 2:BOX 980257
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0257
Mailing Address - Country:US
Mailing Address - Phone:804-828-9783
Mailing Address - Fax:
Practice Address - Street 1:VCUHS DEPT OF SURGERY RESIDENCY, 980135
Practice Address - Street 2:1250 E MARSHALL STREET
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0135
Practice Address - Country:US
Practice Address - Phone:804-628-9789
Practice Address - Fax:804-828-5595
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101273423208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery