Provider Demographics
NPI:1285698043
Name:FREED, MICHAEL H (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:FREED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON STREET
Mailing Address - Street 2:LINDEN BUILDING, FIRST FLOOR
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-6615
Mailing Address - Country:US
Mailing Address - Phone:781-769-4640
Mailing Address - Fax:781-769-3808
Practice Address - Street 1:800 WASHINGTON STREET
Practice Address - Street 2:LINDEN BUILDING, FIRST FLOOR
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-6615
Practice Address - Country:US
Practice Address - Phone:781-769-4640
Practice Address - Fax:781-769-3808
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76922207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE56978Medicare UPIN
MAJ13244Medicare ID - Type Unspecified