Healthcare Provider Details

I. General information

NPI: 1508149402
Provider Name (Legal Business Name): SUZIE FRIEDMAN DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11710 BUSINESS BLVD
EAGLE RIVER AK
99577-7724
US

IV. Provider business mailing address

11710 BUSINESS BLVD
EAGLE RIVER AK
99577-7724
US

V. Phone/Fax

Practice location:
  • Phone: 907-694-3800
  • Fax:
Mailing address:
  • Phone: 907-694-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number661
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: