Provider Demographics
NPI:1750506028
Name:FREEMAN, ANDREW GLEN (MD, MS, MBA)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GLEN
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD, MS, MBA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8170 CORPORATE PARK DR STE 132
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3300
Mailing Address - Country:US
Mailing Address - Phone:513-202-3733
Mailing Address - Fax:888-303-2914
Practice Address - Street 1:8170 CORPORATE PARK DR STE 132
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3300
Practice Address - Country:US
Practice Address - Phone:513-202-3733
Practice Address - Fax:888-303-2914
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350685002083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35068500OtherOH MEDICAL LICENSE #
F-21956Medicare UPIN