Provider Demographics
NPI:1720873235
Name:FREESMEIER, JOHN HUMBIRD (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HUMBIRD
Last Name:FREESMEIER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 ITASCA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST MARYS PT
Mailing Address - State:MN
Mailing Address - Zip Code:55043-9739
Mailing Address - Country:US
Mailing Address - Phone:651-271-1845
Mailing Address - Fax:
Practice Address - Street 1:2426 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1735
Practice Address - Country:US
Practice Address - Phone:612-302-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program