Healthcare Provider Details

I. General information

NPI: 1447478813
Provider Name (Legal Business Name): STEVEN W FREESTONE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 SOUTH OREM BOULEVARD
OREM UT
84058
US

IV. Provider business mailing address

P.O. BOX 1442
PROVO UT
84603-1442
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-5407
  • Fax: 801-225-5623
Mailing address:
  • Phone: 801-225-5407
  • Fax: 801-225-5623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number1644641205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number1644641205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number1644641205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number1644641205
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code207ZI0100X
TaxonomyImmunopathology Physician
License Number1644641205
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License Number1644641205
License Number StateUT
# 7
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number1644641205
License Number StateUT
# 8
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number1644641205
License Number StateUT
# 9
Primary TaxonomyN
Taxonomy Code207ZP0104X
TaxonomyChemical Pathology Physician
License Number1644641205
License Number StateUT
# 10
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number1644641205
License Number StateUT
# 11
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number1644641205
License Number StateUT
# 12
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number1644641205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: STEVEN W FREESTONE
Title or Position: PHYSICIAN
Credential: MD
Phone: 801-225-5407