Provider Demographics
NPI:1801825351
Name:FREEDBERG, PAUL S (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:FREEDBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7003
Mailing Address - Country:US
Mailing Address - Phone:978-741-4133
Mailing Address - Fax:978-741-7742
Practice Address - Street 1:1 WALLACE BASHAW WAY
Practice Address - Street 2:SUITE 3003
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3875
Practice Address - Country:US
Practice Address - Phone:978-997-1400
Practice Address - Fax:978-997-1401
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-06-21
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Provider Licenses
StateLicense IDTaxonomies
MA40923208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0114995Medicaid
MAD11116Medicare PIN
MA340009555Medicare PIN
A54065Medicare UPIN