Provider Demographics
NPI:1811086457
Name:FREEDMAN, ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
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 1:6127 KINGS MOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-1920
Mailing Address - Country:US
Mailing Address - Phone:770-979-2828
Mailing Address - Fax:770-979-3139
Practice Address - Street 1:1700 TREE LN
Practice Address - Street 2:SUITE 490
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-979-2828
Practice Address - Fax:770-979-3139
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21690207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00245495JMedicaid
GA1508926759OtherGROUP NPI NUMBER
GA1811086457OtherPROVIDER NPI NUMBER
GA4188940003Medicare NSC
900003458Medicare PIN
GA1508926759OtherGROUP NPI NUMBER
GA00245495JMedicaid