Individual
JEFFRY SCOTT FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Mailing address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003249
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070C910440
BLUE CROSS & BLUE SHIELD
MI
Enumeration date
08/31/2006
Last updated
06/03/2014
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