FRIEDLAND, JEFFREY (MD)

Provider Demographics

• NPI: 1083691877
• Name: FRIEDLAND, JEFFREY (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: JEFFREY
• Last Name: FRIEDLAND
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 501 E HAMPDEN AVE
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80113-2702
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2005-12-22
• Last Update Date: 2022-12-09

Provider Licenses

State	License ID	Taxonomies
TX	R1028	2085R0202X
NE	25035	2085R0202X
KS	04-36404	2085R0202X
HI	MD17476	2085R0202X
TN	54255	2085R0202X
CO	36954	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MI	104686140	Medicaid
CA	1083691877	Medicaid
OK	200025500A	Medicaid
MO	209903707	Medicaid
CO	01369545	Medicaid
NY	02567619	Medicaid
MT	1083691877	Medicaid
OK	200025500 A	Medicaid
IN	200912930	Medicaid
TX	171606001	Medicaid
NM	29535280	Medicaid
NC	7617656	Medicaid
SD	1083691877	Medicaid
IA	1083691877	Medicaid
WY	118495400	Medicaid
UT	1083691877	Medicaid
AL	1063691877	Medicaid
ME	1083691877	Medicaid
NE	10025709000	Medicaid
ID	1083691877	Medicaid
TN	1530353	Medicaid
AZ	374786	Medicaid
MO	1083691877	Medicaid
MD	3345190 00	Medicaid
NE	84-059792913	Medicaid
ID	1083691877	Medicaid
NE	NA1214018	Medicare PIN
WY	118495400	Medicaid
UT	1083691877	Medicaid
NE	NA2517047	Medicare PIN
MD	3345190 00	Medicaid
NY	02567619	Medicaid
NE	10025709000	Medicaid
AL	1063691877	Medicaid
TX	171606001	Medicaid
OK	200025500 A	Medicaid
NE	84-059792913	Medicaid
CO	390911ZLJ3	Medicare PIN
MT	1083691877	Medicaid
KS	200254500A	Medicare PIN
KS	KA3249068	Medicare PIN