Provider Demographics
NPI:1033496401
Name:FRIED, DENNIS ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALAN
Last Name:FRIED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 TERNBERRY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-6446
Mailing Address - Country:US
Mailing Address - Phone:843-568-9160
Mailing Address - Fax:
Practice Address - Street 1:680 TERNBERRY FOREST DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-6446
Practice Address - Country:US
Practice Address - Phone:843-568-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7140208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery