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Individual
THEODORE TREIBICK
Active
Individual
THEODORE TREIBICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
46320
MA
208D00000X
General Practice Physician
Primary
46320
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110002031
—
MA
01
—
1609920776
WELLSENSE HEALTH PLAN160
—
01
—
70010000B12009
BCBSMA
—
01
—
703314
TUFTS
—
Enumeration date
01/23/2007
Last updated
03/20/2023
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