Provider Demographics
NPI:1285669259
Name:FREEMAN, KALEV (MD)
Entity Type:Individual
Prefix:
First Name:KALEV
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 BAY AVENUE
Mailing Address - Street 2:P.O. BOX 182
Mailing Address - City:GREEN HARBOR
Mailing Address - State:MA
Mailing Address - Zip Code:02041
Mailing Address - Country:US
Mailing Address - Phone:617-414-4075
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER
Practice Address - Street 2:ONE BOSTON MEDICAL CENTER PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227217207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine