MEDICARE: DR. HERBERT FRIED KROHN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	38920	MA
2	207R00000X	Internal Medicine Physician	38920	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	710755	OTHER	MA	TUFTS HEALTH PLAN
3	B11577	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1912998360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT FRIED KROHN MD

Provider Business Mailing Address
First Line	:	PO BOX 9142
Second Line	:	MASS GENERAL PHYSICIAN ORGANIZATION
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-9142
Country	:	US
Telephone Number	:	617-884-8302
Fax Number	:	617-887-3704

Provider Business Practice Location Address
First Line	:	151 EVERETT AVE
Second Line	:	CHC CHELSEA HEALTHCARE CENTER- URGENT CARE
City	:	CHELSEA
State	:	MA
Zip	:	02150-1812
Country	:	US
Telephone Number	:	617-884-8302
Fax Number	:	617-887-3704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	07/30/2012

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Directions to “ DR. HERBERT FRIED KROHN MD” Practice Location

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