Healthcare Provider Details

I. General information

NPI: 1194793877
Provider Name (Legal Business Name): KEITH FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR SUITE 400
COLUMBIA MD
21044-2858
US

IV. Provider business mailing address

10710 CHARTER DR STE 400
COLUMBIA MD
21044-3276
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-7979
  • Fax: 410-997-9231
Mailing address:
  • Phone: 410-997-7979
  • Fax: 410-997-9231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD56645
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: