MEDICARE: DION FREEMAN ED.S

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1619635208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DION FREEMAN ED.S

Provider Business Mailing Address
First Line	:	10348 SE 24TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6064
Country	:	US
Telephone Number	:	678-778-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	10348 SE 24TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6064
Country	:	US
Telephone Number	:	678-778-1526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	12/02/2021

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Directions to “ DION FREEMAN ED.S” Practice Location

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