Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1452 | MA |
NPI | 1578521951 |
---|---|
Provider Name | Dr. Mark D. Friedman |
First Address | Swampscott, MA 01907-1831 |
Second Address | Swampscott, MA 01907-1831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 27/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043243520 | CHICKERING INDIVIDUAL (01) | MA |
043243520 | CIGNA INDIVIDUAL (01) | MA |
043243520 | DEFINITY INDIVIDUAL (01) | MA |
043243520 | GIC INDEMNITY IND. (01) | MA |
043243520 | HARVARD PILGRIM (01) | MA |
043243520 | US DEPARTMENT OF LABOR (01) | MA |
4400309 | UNITED HEALTHCARE IND. (01) | MA |
732774 | TUFTS INDIVIDUAL (01) | MA |
781851 | AETNA INDIVIDUAL (01) | MA |
Y36004 | (02) | MA |
Y39401 | (02) | MA |