Provider Demographics
NPI:1093821555
Name:FRIEDMAN, MARC PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:PHILLIP
Last Name:FRIEDMAN
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 1:3525 PRYTANIA ST
Mailing Address - Street 2:STE 430
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-897-7878
Mailing Address - Fax:504-897-2064
Practice Address - Street 1:3525 PRYTANIA ST STE 430
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3591
Practice Address - Country:US
Practice Address - Phone:504-897-7878
Practice Address - Fax:504-897-2064
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011584207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1797537Medicaid
5L072Medicare ID - Type Unspecified
C67218Medicare UPIN
LA1797537Medicaid