Individual
DR. KENNETH ALAN FREEDBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, COX 5 INFECTIOUS DISEASE ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-3906
(617) 726-2691
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58123
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058123
TUFTS HEALTH PLAN
MA
05
—
3051480
—
MA
01
—
J08534
BCBS MA
MA
Enumeration date
11/16/2005
Last updated
07/08/2007
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