MEDICARE: DR. STEPHEN SIMON FRIEDMAN D.O.

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	207Q00000X	Family Medicine Physician	5101004669	MI

General Provider Information

NPI Number	:	1952508467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN SIMON FRIEDMAN D.O.

Provider Business Mailing Address
First Line	:	2960 MIDDLEBELT RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-1931
Country	:	US
Telephone Number	:	248-738-5952
Fax Number	:	248-683-8039

Provider Business Practice Location Address
First Line	:	2960 MIDDLEBELT RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-1931
Country	:	US
Telephone Number	:	248-738-5952
Fax Number	:	248-683-8039

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

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	07/08/2007

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