Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DO83326 | SC |
Y | 111NI0900X | Internist | DO83326 | SC |
NPI | 1003357948 |
---|---|
Provider Name | Dr. Keith Freeman |
First Address | Taylors, SC 29687-6085 |
Second Address | Greenville, SC 29615-3534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2017 |
Last Update Date | 20/07/2020 |