Healthcare Provider Details

I. General information

NPI: 1679757306
Provider Name (Legal Business Name): STEVEN FRYDMAN DPM SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7929 N 76TH ST
MILWAUKEE WI
53223-3947
US

IV. Provider business mailing address

7929 N 76TH ST
MILWAUKEE WI
53223-3947
US

V. Phone/Fax

Practice location:
  • Phone: 414-371-1000
  • Fax: 414-371-1256
Mailing address:
  • Phone: 414-371-1000
  • Fax: 414-371-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number382-025
License Number StateWI

VIII. Authorized Official

Name: DR. STEVEN FRYDMAN
Title or Position: PRESIDENT
Credential: DPM
Phone: 414-371-1000