Provider Demographics
NPI:1396737425
Name:FREEMAN, STEVEN D (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 N REYNOLDS RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2068
Mailing Address - Country:US
Mailing Address - Phone:419-578-4280
Mailing Address - Fax:419-537-5684
Practice Address - Street 1:2865 N REYNOLDS RD
Practice Address - Street 2:SUITE 260
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2068
Practice Address - Country:US
Practice Address - Phone:419-578-4280
Practice Address - Fax:419-537-5684
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063043207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000512814OtherANTHEM
01979OtherPARAMOUNT
P00387813OtherRRMC
4647922OtherAETNA
OH0169115Medicaid
OH0169115Medicaid
OHG04899Medicare UPIN
P00387813OtherRRMC