Provider Demographics
NPI:1801863816
Name:BARTLETT, FREDERICK F (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:F
Last Name:BARTLETT
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 1:300 MT AUBURN STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-2138
Mailing Address - Country:US
Mailing Address - Phone:617-868-7456
Mailing Address - Fax:617-868-9243
Practice Address - Street 1:300 MT AUBURN STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-2138
Practice Address - Country:US
Practice Address - Phone:617-868-7456
Practice Address - Fax:617-868-9243
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49394174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3011224Medicaid
MAJ0531901Medicare PIN