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NPI Code Detail

MEDICARE: BRUCE C FRIEDMAN M.D.

MEDICARE: BRUCE C FRIEDMAN M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician040066GA
2207R00000XInternal Medicine Physician040066GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417939315
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE C FRIEDMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 16187
Second Line :
City : AUGUSTA
State : GA
Zip : 30919-2187
Country : US
Telephone Number : 706-504-4651
Fax Number : 706-504-4639
Provider Business Practice Location Address
First Line : 3651 WHEELER RD
Second Line : BURN CENTER
City : AUGUSTA
State : GA
Zip : 30909-6521
Country : US
Telephone Number : 706-504-4651
Fax Number : 706-504-4639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 10/03/2011

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