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General NPI Number Information
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NPI Number | 1134481047
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Entity Type | Individual
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Provider Name | FRED FRIDMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 335 BRIGHTON AVE
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City | PORTLAND
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State | ME
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Zip | 04102-2363
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Country | US
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Telephone | 207-775-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 136 LINDEN DR STE 104
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City | WINCHESTER
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State | VA
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Zip | 22601-6900
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Country | US
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Telephone | 540-504-0118
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Fax | 207-888-3733
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 18858
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | DO2594
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS20698
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License Number State | FL
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