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Individual
FREEMAN TICHATONGA CHANGAMIRE
Active
Individual
FREEMAN TICHATONGA CHANGAMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., SC.D., MBA
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
244111
MA
207Q00000X
Family Medicine Physician
38679
SC
207Q00000X
Family Medicine Physician
Primary
50191
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001121829
ANTHEM-KY
KY
05
—
110086725/A
—
MA
01
—
234001
SIHO
KY
05
—
386790
—
SC
01
—
K231120
MEDICARE
KY
Enumeration date
07/09/2007
Last updated
12/26/2017
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