Organization
GLENN FREED DO PC
Active
Organization
GLENN FREED DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN FREED DO (OWNER)
(570) 622-3366
Entity
Organization
Contact information
Practice address
100 SCHUYLKILL MEDICAL PLZ, SUITE 101, POTTSVILLE, PA 17901-3663
(570) 622-3366
(570) 622-6638
Mailing address
100 SCHUYLKILL MEDICAL PLZ, SUITE 101, POTTSVILLE, PA 17901-3663
(570) 622-3366
(570) 622-6638
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02700200
CAPITAL BLUE CROSS
PA
01
—
1677099
HIGHMARK BS
—
01
—
P00178931
TRAVELERS MEDICARE
PA
Enumeration date
01/31/2006
Last updated
10/18/2007
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