Provider Demographics
NPI:1124474564
Name:FREIBERG, MARINA NADER BOUSHRA (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:NADER BOUSHRA
Last Name:FREIBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARINA
Other - Middle Name:NADER
Other - Last Name:BOUSHRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-3409
Practice Address - Country:US
Practice Address - Phone:216-906-2798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-01000207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine