Healthcare Provider Details

I. General information

NPI: 1609803030
Provider Name (Legal Business Name): DAVID I FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR MEP / SHADY GROVE ADVENTIST HOSPTIAL EMERGENCY DEPT.
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-6550
  • Fax:
Mailing address:
  • Phone: 410-933-2704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberD63782
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberD63782
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: