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General NPI Number Information
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NPI Number | 1720102288
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Entity Type | Individual
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Provider Name | CARTER BOLTON FREIBURG M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 520 UPPER CHESAPEAKE DR SUITE 306 AMBULATORY CARE CENTER
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City | BEL AIR
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State | MD
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Zip | 21014-4339
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Country | US
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Telephone | 410-879-2006
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Fax | 410-420-2006
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Provider Business Mailing Address
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Address Line | 520 UPPER CHESAPEAKE DR SUITE 306 AMBULATORY CARE CENTER
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City | BEL AIR
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State | MD
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Zip | 21014-4339
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Country | US
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Telephone | 410-879-2006
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Fax | 410-420-2006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | BF4323200SW
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | D0071822
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License Number State | MD
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