Individual
JONATHAN SETH FRIEDSTAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, GRB 1303, FRASIER OUTPATIENT BURN CENTER, BOSTON, MA 02114
(617) 726-3712
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-3712
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ML20008564
WA
2086S0102X
Surgical Critical Care Physician
246710
MA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
Q2768
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347245801 (MDACC)
—
TX
Enumeration date
08/30/2006
Last updated
04/09/2018
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