Provider Demographics
NPI:1861586034
Name:FREIJ, WALID WAJIH (MD)
Entity type:Individual
Prefix:DR
First Name:WALID
Middle Name:WAJIH
Last Name:FREIJ
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 1:217 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-4589
Mailing Address - Country:US
Mailing Address - Phone:334-872-8627
Mailing Address - Fax:334-872-8629
Practice Address - Street 1:217 BROAD ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-4589
Practice Address - Country:US
Practice Address - Phone:334-872-8627
Practice Address - Fax:334-872-8629
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL187552084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529702780Medicaid
AL130016634OtherRAILROAD MEDICARE
AL7562326OtherAETNA
AL270304OtherPRIME HEALTH
AL000032578Medicaid
AL32578OtherBLUE CROSS/BLUE SHIELD