Provider Demographics
NPI:1679749253
Name:FREEMAN, CHARA CHINYERE (MD)
Entity type:Individual
Prefix:MS
First Name:CHARA
Middle Name:CHINYERE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1225
Mailing Address - Fax:704-384-1226
Practice Address - Street 1:8310 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 550
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3383
Practice Address - Country:US
Practice Address - Phone:704-384-1225
Practice Address - Fax:704-384-1226
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24482207Q00000X
TXS3814207Q00000X
NC2012-01918207Q00000X
IN01081378A207Q00000X
VA0101267250207Q00000X
RIMD16468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020826Medicaid
WVWV0272CMedicare PIN
WV3810020826Medicaid
WVWV0272AMedicare PIN