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General NPI Number Information
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NPI Number | 1013095330
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Entity Type | Individual
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Provider Name | ROBERT FRIED MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 1510 NC HIGHWAY 68 N
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City | OAK RIDGE
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State | NC
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Zip | 27310-9733
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Country | US
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Telephone | 336-644-0111
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Fax | 336-644-0085
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Provider Business Mailing Address
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Address Line | PO BOX 14883
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City | GREENSBORO
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State | NC
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Zip | 27415-4883
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Country | US
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Telephone | 336-644-0111
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Fax | 336-644-0085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25798
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License Number State | NC
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