Provider Demographics
NPI:1720102288
Name:FREIBURG, CARTER BOLTON (MD)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:BOLTON
Last Name:FREIBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 306 AMBULATORY CARE CENTER
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:410-879-2006
Mailing Address - Fax:410-420-2006
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 306 AMBULATORY CARE CENTER
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:410-879-2006
Practice Address - Fax:410-420-2006
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VTBF4323200SW208600000X
MDD00718222086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery