Provider Demographics
NPI:1093799637
Name:FRIEDLAND MD PC, MARK S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:FRIEDLAND MD PC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:44199 DEQUINDRE RD
Mailing Address - Street 2:STE 623
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085
Mailing Address - Country:US
Mailing Address - Phone:248-828-5707
Mailing Address - Fax:248-828-5702
Practice Address - Street 1:44199 DEQUINDRE RD
Practice Address - Street 2:STE 623
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:248-828-5707
Practice Address - Fax:248-828-5702
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2007-10-30
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Provider Licenses
StateLicense IDTaxonomies
MI43010643352086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0633267OtherBLUE CROSS
0633267OtherBLUE CROSS
G23903Medicare UPIN