Provider Demographics
NPI:1083637839
Name:FREIDENBERG, DAVID H (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:FREIDENBERG
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 1:2215 SUNSET AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2148
Mailing Address - Country:US
Mailing Address - Phone:206-226-2397
Mailing Address - Fax:
Practice Address - Street 1:2215 SUNSET AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2148
Practice Address - Country:US
Practice Address - Phone:206-226-2397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-8583207P00000X
WA0021021207P00000X
CAG87581207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A06465Medicare UPIN