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Individual

CHARLES G. FREEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 US HIGHWAY 61, SUITE 340, FESTUS, MO 63028-4100
(636) 937-1545
(636) 937-8995
Mailing address
1400 US HIGHWAY 61, SUITE 340, FESTUS, MO 63028-4100
(636) 937-1545
(636) 937-8995

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R9916
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201490927
MO
Enumeration date
09/29/2006
Last updated
12/01/2014
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