MEDICARE: ROGER S. FRIEDEN 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	208000000X	Pediatrics Physician	7807	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2192432	OTHER	NH	AETNA PIN
2	P674376	OTHER	NH	OXFORD
3	12-40727	OTHER	NH	UHC PIN
4	406446	OTHER	NH	TUFTS
5	20024Y	OTHER	NH	ANTHEM REFERRING RAN
6	HLO030	OTHER	NH	HPHC
7	0102584YPNH01	OTHER	NH	ANTHEM ACES PIN
8	2123	OTHER	NH	CIGNA PIN

General Provider Information

NPI Number	:	1669462354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER S. FRIEDEN MD

Provider Business Mailing Address
First Line	:	275 MAMMOTH RD
Second Line	:	SUITE 2
City	:	MANCHESTER
State	:	NH
Zip	:	03109-4133
Country	:	US
Telephone Number	:	603-663-8300
Fax Number	:	603-663-8349

Provider Business Practice Location Address
First Line	:	275 MAMMOTH RD
Second Line	:	SUITE 2
City	:	MANCHESTER
State	:	NH
Zip	:	03109-4133
Country	:	US
Telephone Number	:	603-663-8300
Fax Number	:	603-663-8349

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	02/26/2014

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Directions to “ ROGER S. FRIEDEN MD” Practice Location

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