Active NPI
Michael Freedman, MD
- Psychiatry Physician
- Southfield, MI
National Provider Identifier
1114062262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301028738
- Practice address
- 24725 W 12 Mile Rd Ste 310
Southfield, MI 48034-8337 - Phone
- (248) 351-0011
- Fax
- (248) 351-0017
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301028738 | MI | Primary |
Addresses
Primary practice location
24725 W 12 Mile Rd Ste 310
Southfield, MI 48034-8337
Mailing address
24725 W 12 Mile Rd Ste 310
Southfield, MI 48034-8337
Phone (248) 351-0011
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1373563 | Medicaid | MI | |
| 2606303270 | Other | MI | BCBSM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301028738 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1114062262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24725 W 12 MILE RD STE 310",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480348337",
"telephone_number": "248-351-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24725 W 12 MILE RD STE 310",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480348337",
"telephone_number": "248-351-0011",
"fax_number": "248-351-0017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301028738",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1373563",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "2606303270",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
- Carolyn Frazier, NURSE PRACTITIONER
- Ericka Tiphany Frederick, SCL, LLC
- Kathleen C Frederick
- Kathleen Frederiksen, LMSW
- Free Spirit Hospice Care, LLC (Free Spirit)
- Richard Freedman, L.M.S.W.
- Freedom Choice Homehealthcare
- Freedom Wheelchairs & Equipment, Inc.
- Yolonda Faye Freeman-Hildreth, PA
- Noah Edward Freiburger, DNP, PMHNP-BC, CBIS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.