Provider Demographics
NPI:1548293707
Name:DREWS, FREDDY B (MD)
Entity type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:B
Last Name:DREWS
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 1:5655 HUDSON DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4451
Mailing Address - Country:US
Mailing Address - Phone:330-655-3800
Mailing Address - Fax:330-655-3828
Practice Address - Street 1:5655 HUDSON DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4451
Practice Address - Country:US
Practice Address - Phone:330-655-3800
Practice Address - Fax:330-655-3828
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0795472085R0202X
OH35.0795472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221244OtherUNISON
OH0304914OtherBCMH
OHP00412318OtherRAILROAD MEDICARE
OH000000503573OtherANTHEM
OH363492OtherWELLCARE
OH7273270OtherAETNA
OH2268586Medicaid
OH732391OtherBUCKEYE
OH2268586Medicaid
OH4055288Medicare PIN
OH000000503573OtherANTHEM
H41974Medicare UPIN