Provider Demographics
NPI:1629053749
Name:ADULT MEDICINE SPECIALISTS OF EASLEY PA
Entity Type:Organization
Organization Name:ADULT MEDICINE SPECIALISTS OF EASLEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-855-5525
Mailing Address - Street 1:764 SACO LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3880
Mailing Address - Country:US
Mailing Address - Phone:864-855-5525
Mailing Address - Fax:864-855-5440
Practice Address - Street 1:764 SACO LOWELL RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3880
Practice Address - Country:US
Practice Address - Phone:864-855-5525
Practice Address - Fax:864-855-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC186952Medicaid
G67386Medicare UPIN
SC7714Medicare ID - Type Unspecified