Healthcare Provider Details

I. General information

NPI: 1275520678
Provider Name (Legal Business Name): DAVID FRIED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1598 S COUNTY TRL STE 201
EAST GREENWICH RI
02818-1762
US

IV. Provider business mailing address

10 DAVOL SQ SUITE 400
PROVIDENCE RI
02903-4754
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-0333
  • Fax: 401-884-0096
Mailing address:
  • Phone: 401-421-4000
  • Fax: 401-272-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD07840
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: