Provider Demographics
NPI:1548347875
Name:FREEDMAN, HARRIS (DO)
Entity type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 714328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-4328
Mailing Address - Country:US
Mailing Address - Phone:440-602-6770
Mailing Address - Fax:440-975-0208
Practice Address - Street 1:36100 EUCLID AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-602-6770
Practice Address - Fax:440-975-0208
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34 -003413F207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC02730Medicare UPIN