Healthcare Provider Details

I. General information

NPI: 1497170468
Provider Name (Legal Business Name): MEAGAN FREEMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGAN BUTSCH DO

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 08/17/2023
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER ATTN: MCEU-LCM-MSO UNIT 33100
APO AE
09180
US

IV. Provider business mailing address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 713-303-1697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1392
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number1392
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: