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General NPI Number Information
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NPI Number | 1770603680
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Entity Type | Organization
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Legal Business Name | FRIEDMAN SURGICAL GROUP P C
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14555 LEVAN RD STE 307
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City | LIVONIA
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State | MI
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Zip | 48154-5085
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Country | US
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Telephone | 734-462-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 14555 LEVAN RD STE 307
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City | LIVONIA
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State | MI
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Zip | 48154-5085
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Country | US
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Telephone | 734-462-1525
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL FRIEDMAN
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Credential | M D
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Telephone | 734-462-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | PF05768
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License Number State | MI
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