Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD020602E | PA |
NPI | 1033197587 |
---|---|
Provider Name | Dr. Mark Charles Friedman |
First Address | Harrisburg, PA 17111-3744 |
Second Address | Harrisburg, PA 17111-3744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 11/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007414400002 | (05) | PA |
C26792 | (02) | PA |