Healthcare Provider Details

I. General information

NPI: 1093821555
Provider Name (Legal Business Name): MARC PHILLIP FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 PRYTANIA ST STE 430
NEW ORLEANS LA
70115-3591
US

IV. Provider business mailing address

3525 PRYTANIA ST STE 430
NEW ORLEANS LA
70115
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-7878
  • Fax: 504-897-2064
Mailing address:
  • Phone: 504-897-7878
  • Fax: 504-897-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number011584
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number011584
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: