Provider Demographics
NPI:1033109830
Name:FREEMAN, FRED A (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:A
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:C200
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-537-8710
Mailing Address - Fax:785-537-0562
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:C200
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-537-8710
Practice Address - Fax:785-537-0562
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-14433208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B91004Medicare UPIN