Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 45818 | CO |
Y | 2080P0202X | Pediatric Cardiologist | FF2575186 | MA |
NPI | 1003962614 |
---|---|
Provider Name | Kevin Friedman |
First Address | Denver, CO 80262-0001 |
Second Address | Denver, CO 80262-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 18/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
45818 | (05) | CO |