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General NPI Number Information
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NPI Number | 1972824506
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Entity Type | Individual
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Provider Name | JAMES DAVID FREEMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 08/17/2024
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Provider Practice Location Address
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Address Line | 106 TOKEN CT
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City | KATHLEEN
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State | GA
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Zip | 31047-4114
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Country | US
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Telephone | 706-969-9694
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 AZALEA CT STE C
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5765
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Country | US
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Telephone | 352-265-0291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME123857
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License Number State | FL
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