Healthcare Provider Details

I. General information

NPI: 1730160219
Provider Name (Legal Business Name): RICHARD B. FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 WEBSTER ST
MANCHESTER NH
03104-2512
US

IV. Provider business mailing address

138 WEBSTER ST
MANCHESTER NH
03104-2512
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-7030
  • Fax: 603-663-7039
Mailing address:
  • Phone: 603-663-7030
  • Fax: 603-663-7039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number5480
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0408785
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerUHC PIN
# 2
Identifier3696947
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerCIGNA PIN
# 3
Identifier714604
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerTUFTS PIN
# 4
IdentifierAA17336
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerHPHC PIN
# 5
IdentifierE10032
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerANTHEM REFERRING UPIN
# 6
IdentifierP00139541
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerRR MEDICARE PIN
# 7
Identifier3667960
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerAETNA PIN
# 8
Identifier30201970
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: