Individual
EARL R FREEMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
21 WESTERN AVE # A, KENNEBUNK, ME 04043-7354
(207) 967-3726
(207) 967-3702
Mailing address
PO BOX 648, KENNEBUNKPORT, ME 04046-0648
(207) 967-3726
(207) 967-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
835
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060928
ANTHEM BX/BS
ME
05
—
206880000
—
ME
01
—
352215816
CHAMPUS
—
Enumeration date
07/10/2006
Last updated
07/08/2007
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