MEDICARE: DR. CRAIG S FRIEDMAN D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	00933	MD

General Provider Information

NPI Number	:	1265549141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG S FRIEDMAN D.P.M.

Provider Business Mailing Address
First Line	:	5404 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-4405
Country	:	US
Telephone Number	:	410-358-5588
Fax Number	:	410-358-7202

Provider Business Practice Location Address
First Line	:	5404 REISTERSTOWN RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-4405
Country	:	US
Telephone Number	:	410-358-5588
Fax Number	:	410-358-7202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	10/28/2011

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