Healthcare Provider Details

I. General information

NPI: 1952338469
Provider Name (Legal Business Name): LOREN L. FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8503 ARLINGTON BLVD STE 400
FAIRFAX VA
22031-4629
US

IV. Provider business mailing address

3040 WILLIAMS DR SUITE 100
FAIRFAX VA
22031-4618
US

V. Phone/Fax

Practice location:
  • Phone: 703-280-5390
  • Fax: 703-280-9596
Mailing address:
  • Phone: 703-208-3963
  • Fax: 703-205-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number0101046772
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number0101046772
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: