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NPI Code Detail

MEDICARE: DR. SCOTT A. TRIEDMAN M.D.

MEDICARE: DR. SCOTT A. TRIEDMAN 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
12085R0001XRadiation Oncology Physician07736RI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2300020526OTHERRIRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538162508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT A. TRIEDMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 54589
Second Line :
City : LOS ANGELES
State : CA
Zip : 90054-0589
Country : US
Telephone Number : 508-941-7450
Fax Number : 508-941-6205
Provider Business Practice Location Address
First Line : 825 N MAIN ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02904-5707
Country : US
Telephone Number : 401-521-9700
Fax Number : 401-751-1686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 06/01/2015

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