Provider Demographics
NPI:1770581142
Name:FREEMAN, DAVID ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROSS
Last Name:FREEMAN
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 1:901B WEST ST
Mailing Address - Street 2:
Mailing Address - City:WILKINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2833
Mailing Address - Country:US
Mailing Address - Phone:412-247-4007
Mailing Address - Fax:
Practice Address - Street 1:901B WEST ST
Practice Address - Street 2:
Practice Address - City:WILKINSBURG
Practice Address - State:PA
Practice Address - Zip Code:15221-2833
Practice Address - Country:US
Practice Address - Phone:412-247-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047756L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1654887Medicaid
PAF59404Medicare UPIN