Provider Demographics
NPI:1982749396
Name:SHELDON FREEDMAN MD LTD
Entity Type:Organization
Organization Name:SHELDON FREEDMAN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-732-0282
Mailing Address - Street 1:653 N TOWN CENTER DR STE 308
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0517
Mailing Address - Country:US
Mailing Address - Phone:702-732-0282
Mailing Address - Fax:702-369-6981
Practice Address - Street 1:653 N TOWN CENTER DR STE 308
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0517
Practice Address - Country:US
Practice Address - Phone:702-732-0282
Practice Address - Fax:702-369-6981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4828208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCN9490Medicare Oscar/Certification
NVVWCHJMMedicare PIN