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Individual

DR. KEVIN STEWART FREEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
33 UPPER RIVERDALE RD SW, SUITE 114, RIVERDALE, GA 30274-2626
(770) 991-1624
(770) 991-9206
Mailing address
33 UPPER RIVERDALE RD SW, SUITE 114, RIVERDALE, GA 30274-2626
(770) 991-1624
(770) 991-9206

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
034344
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00468036A
GA
01
180012853
PALMETTO GBA
GA
Enumeration date
08/10/2006
Last updated
04/22/2008
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