MEDICARE: DR. STEVEN GENE FRIEDENBERG DVM

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	174M00000X	Veterinarian	17738	CA
2	174M00000X	Veterinarian	7721	NC

General Provider Information

NPI Number	:	1992933956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN GENE FRIEDENBERG DVM

Provider Business Mailing Address
First Line	:	1988 FITCH AVE
Second Line	:	295T AS/VM
City	:	SAINT PAUL
State	:	MN
Zip	:	55108-6009
Country	:	US
Telephone Number	:	612-625-7744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1988 FITCH AVE
Second Line	:	295T AS/VM
City	:	SAINT PAUL
State	:	MN
Zip	:	55108-6009
Country	:	US
Telephone Number	:	612-625-7744
Fax Number	:

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

Provider Enumeration Date	:	06/29/2009
Last Update Date	:	10/01/2016

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