Individual
LAURA A FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2955 XENIUM LN N STE 40, PLYMOUTH, MN 55441-2668
(763) 559-2171
Mailing address
2800 CAMPUS DR STE 10, PLYMOUTH, MN 55441-2669
(763) 559-2171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
52220
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P01215717
RAILROAD MEDICARE
MN
Enumeration date
07/08/2008
Last updated
09/17/2022
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