Healthcare Provider Details

I. General information

NPI: 1740233675
Provider Name (Legal Business Name): ADRIANA FREEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/04/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LYONS ST
DEDHAM MA
02026-5599
US

IV. Provider business mailing address

1 LYONS ST
DEDHAM MA
02026-5599
US

V. Phone/Fax

Practice location:
  • Phone: 781-493-3600
  • Fax: 781-329-6479
Mailing address:
  • Phone: 781-493-3600
  • Fax: 781-329-6479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number220695
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: