Healthcare Provider Details

I. General information

NPI: 1427054683
Provider Name (Legal Business Name): DAVID J. FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ACADEMY ST S
AHOSKIE NC
27910-3264
US

IV. Provider business mailing address

PO BOX 31001-0698
PASADENA CA
91110-0698
US

V. Phone/Fax

Practice location:
  • Phone: 252-209-5404
  • Fax: 602-200-5383
Mailing address:
  • Phone: 602-263-1200
  • Fax: 602-200-5383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number8245
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: