Provider Demographics
NPI:1699775122
Name:FREEMAN, STEPHEN B (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12188 A NORTH MERIDIAN ST
Mailing Address - Street 2:SUITE 375
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4578
Mailing Address - Country:US
Mailing Address - Phone:317-926-1056
Mailing Address - Fax:317-579-0476
Practice Address - Street 1:12188 A NORTH MERIDIAN ST
Practice Address - Street 2:SUITE 375
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4578
Practice Address - Country:US
Practice Address - Phone:317-926-1056
Practice Address - Fax:317-579-0476
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01030307207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100332520Medicaid
IN100332520Medicaid
IN088110HMedicare ID - Type Unspecified