Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 29636 | MO |
NPI | 1598892838 |
---|---|
Provider Name | William H Friedman |
First Address | Saint Louis, MO 63131-2330 |
Second Address | Saint Louis, MO 63131-2330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A29076 | (02) | MO |