Individual
BRUCE PALMER FRESHLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
94991
GA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
82649
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
94991
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2019
Last updated
09/18/2023
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