Healthcare Provider Details

I. General information

NPI: 1851205967
Provider Name (Legal Business Name): DR. SCOTT FREEMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5357 RAVENDALE CIR
LAS VEGAS NV
89120-2078
US

IV. Provider business mailing address

5357 RAVENDALE CIR
LAS VEGAS NV
89120-2078
US

V. Phone/Fax

Practice location:
  • Phone: 202-494-0284
  • Fax:
Mailing address:
  • Phone: 202-494-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD.09131R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: