Provider Demographics
NPI:1780798165
Name:FREEDMAN, GEORGE STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:STEPHEN
Last Name:FREEDMAN
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 1:564 LORING AVE.
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-745-8575
Mailing Address - Fax:978-745-8633
Practice Address - Street 1:564 LORING AVE.
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-745-8575
Practice Address - Fax:978-745-8633
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA347902084P0800X
MAMASS347902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A54225Medicare UPIN
O28120Medicare UPIN