DONALD S FREEDMAN MD PA NPI 1730378043

NPI Information

NPI: 1730378043
Provider Name: DONALD S FREEDMAN MD PA

Doing Business As: NORTHSIDE MEDICAL CLINIC

Classification: General Practice - 208D00000X
Entity Type: Organization

Address:
480 BUSCH DR
JACKSONVILLE, FL
ZIP 32218
Phone: (904) 764-5000
Get Directions

DONALD S FREEDMAN MD PA is a general practice in Jacksonville, FL. DONALD S FREEDMAN MD PA NPI is 1730378043. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northside Medical Clinic.

The provider's business location address is:

480 BUSCH DR
JACKSONVILLE, FL
ZIP 32218-553
Phone: (904) 764-5000

The provider's authorized official is Sharon Minger Wilson .
The authorized official title is Office Administrator and has the following contact phone number (904) 764-5000.

The CLIA number assigned to this NPI record is 10D1029945 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2007 and was last updated on 4/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	ME 31964	FLORIDA	No
2	207RA0401X	Internal Medicine	Addiction Medicine	OS58811	FLORIDA	No
3	207V00000X	Obstetrics & Gynecology		ME31964	FLORIDA	No
4	208D00000X	General Practice		ME49644	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02690	MEDICARE PIN	FLORIDA
2	62840	OTHER	FLORIDA	BLUE SHIELD OF FLORIDA
3	B57981	MEDICARE UPIN	FLORIDA
4	D61769	MEDICARE UPIN	FLORIDA
5	E11882	MEDICARE UPIN	FLORIDA
6	15435	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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