Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 17216 | WI |
NPI | 1194733345 |
---|---|
Provider Name | Mr. David Zachary Friedberg |
First Address | Milwaukee, WI 53288-0001 |
Second Address | Milwaukee, WI 53226-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30898400 | (05) | WI |
B52906 | (02) | WI |