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Individual

DR. FREDDY R SOSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22250 PROVIDENCE DR, SUITE 703, SOUTHFIELD, MI 48075-4825
(248) 569-1770
(248) 443-2439
Mailing address
22250 PROVIDENCE DR, SUITE 703, SOUTHFIELD, MI 48075-4825
(248) 569-1770
(248) 443-2439

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301029937
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0638265
MEDICARE
MI
01
0638265
BLUE CARE NETWORK
05
104308845
MI
05
1051407
MI
01
110638265
BCBS
01
110Q262840
BCBSM/BCN
MI
01
1S0638265
HEALTH PLUS PPO
MI
01
2437498
CIGNA
MI
01
5133233
AETNA
MI
01
B45138
HAP
MI
Enumeration date
06/07/2006
Last updated
04/22/2014
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