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Individual

LARA A FREEBURGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
330 BARCLAY AVE NE, SUITE 304, GRAND RAPIDS, MI 49503-2556
(616) 391-2160
(616) 391-2683
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 391-2160
(616) 391-2683

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301066218
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821102013
MI
05
4132151
MI
Enumeration date
08/18/2006
Last updated
03/11/2021
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