Healthcare Provider Details

I. General information

NPI: 1275028490
Provider Name (Legal Business Name): MAX FRIEDLANDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 COMMERCE DR STE 160
PERRYSBURG OH
43551-5272
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4231
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-7600
  • Fax: 419-872-7601
Mailing address:
  • Phone: 419-479-5327
  • Fax: 419-479-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34.015791
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.015791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: