Individual
MR. JEREMY M FREITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
870 SUMMIT CROSSING PL, GASTONIA, NC 28054-2192
(704) 867-2333
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07207
NC
363A00000X
Physician Assistant
2127
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730010
NSC #
NC
Enumeration date
08/30/2012
Last updated
04/26/2022
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