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Individual

LAWRENCE K FREITAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
735 FITZWATERTOWN RD, WILLOW GROVE, PA 19090-1332
(215) 657-2012
(215) 657-2018
Mailing address
735 FITZWATERTOWN RD, WILLOW GROVE, PA 19090-1332
(215) 657-2012
(215) 657-2018

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
224133
MA
207RN0300X
Nephrology Physician
Primary
MD431120
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001974706
HIGHMARK BLUE SHIELD
PA
01
0048674000
IBC
01
02334MD431120
HEALTH PARTNERS
05
1019298740001
PA
01
7706849
AETNA PROVIDER NUMBER
PA
01
MD431120
MEDICAL LICENSE
PA
01
P00435581
RAILROAD MEDICARE
Enumeration date
05/30/2006
Last updated
05/22/2008
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