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NPI Code Detail

MEDICARE: STEPHEN JOHN FRESHWATER M.D.

MEDICARE:   STEPHEN JOHN FRESHWATER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35-052289OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1FR 0597792OTHEROHMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245215607
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN JOHN FRESHWATER M.D.
Provider Business Mailing Address
First Line : 906 NORTH MAIN STREET
Second Line : P.O. BOX 319
City : ARLINGTON
State : OH
Zip : 45814-0319
Country : US
Telephone Number : 419-365-5153
Fax Number : 419-365-0081
Provider Business Practice Location Address
First Line : 906 NORTH MAIN STREET
Second Line :
City : ARLINGTON
State : OH
Zip : 45814-0319
Country : US
Telephone Number : 419-365-5153
Fax Number : 419-365-0081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 07/22/2008

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Directions to “ STEPHEN JOHN FRESHWATER M.D.” Practice Location

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