Provider Demographics
NPI:1265472237
Name:FREEMAN, KIM M (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:M
Other - Last Name:WEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:114 NATIONWIDE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4271
Mailing Address - Country:US
Mailing Address - Phone:434-237-9233
Mailing Address - Fax:434-237-9222
Practice Address - Street 1:114 NATIONWIDE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4271
Practice Address - Country:US
Practice Address - Phone:434-237-9233
Practice Address - Fax:434-237-9222
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058119207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010113768Medicaid
VA010113768Medicaid
006230L84Medicare PIN