Healthcare Provider Details

I. General information

NPI: 1366409146
Provider Name (Legal Business Name): MICHAEL ALEXANDER FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

313 IRON WORKS WAY
WAYNE PA
19087-4226
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-7000
  • Fax:
Mailing address:
  • Phone: 610-687-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberW6462
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number56547
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD-053913-L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number81769
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: