Healthcare Provider Details

I. General information

NPI: 1700848157
Provider Name (Legal Business Name): GARY NEAL FRIEDLANDER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 W THUNDERBIRD RD STE G700
GLENDALE AZ
85306
US

IV. Provider business mailing address

5352 E ESTEVAN RD
PHOENIX AZ
85054-7211
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-3600
  • Fax: 602-938-0400
Mailing address:
  • Phone: 602-938-3600
  • Fax: 602-938-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0196
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: