Provider Demographics
NPI:1790760098
Name:TREIBERGS, JURIS EGILS (MD)
Entity Type:Individual
Prefix:DR
First Name:JURIS
Middle Name:EGILS
Last Name:TREIBERGS
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 1:39 PILGRIM RD
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5215
Mailing Address - Country:US
Mailing Address - Phone:781-934-6387
Mailing Address - Fax:508-747-2705
Practice Address - Street 1:323 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4322
Practice Address - Country:US
Practice Address - Phone:508-747-2705
Practice Address - Fax:508-747-5209
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA560252084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3127591Medicaid
MA3127591Medicaid