Provider Demographics
NPI:1679582506
Name:FREEMAN, STEVEN P (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 CORPORATE DR
Mailing Address - Street 2:STE 150
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-7763
Mailing Address - Country:US
Mailing Address - Phone:816-271-1221
Mailing Address - Fax:816-271-4060
Practice Address - Street 1:5514 CORPORATE DR
Practice Address - Street 2:STE 150
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-7763
Practice Address - Country:US
Practice Address - Phone:816-271-1265
Practice Address - Fax:816-271-4060
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-27817207RC0000X
MO110506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100420350BMedicaid
MO248918328Medicaid
KS102028OtherBCBS KS/ KS OUTREACH CLIN
MO31482011OtherBCBS KC
KS100420350AMedicaid
KS100420350AMedicaid
KS100420350BMedicaid
MO038B717AMedicare PIN
KS038B717BMedicare PIN
KS102028Medicare PIN
MO248918328Medicaid
MO038B717EMedicare PIN