Individual
THOMAS ROBERT FREIJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01087850A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010820
MEDICARE PTAN
IN
01
—
1003379090
ANTHEM PTAN
IN
01
—
264430E82
MEDICARE PTAN
IN
05
—
300026114
—
IN
Enumeration date
04/08/2019
Last updated
05/17/2024
Update your record
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