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General NPI Number Information
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NPI Number | 1225354277
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Entity Type | Organization
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Legal Business Name | FRIDBERG ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 510 REVOLUTION ST
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-3318
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Country | US
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Telephone | 410-939-5330
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Fax | 410-939-6204
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Provider Business Mailing Address
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Address Line | 510 REVOLUTION ST
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-3318
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Country | US
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Telephone | 410-939-5330
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Fax | 410-939-6204
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARIANNE F FRIDBERG
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Credential | M.D.
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Telephone | 410-939-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D22433
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License Number State | MD
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