Provider Demographics
NPI:1124007034
Name:FRIEDMAN, BURTON J (MD)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:J
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 1:8025 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RIVER HILLS
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2542
Mailing Address - Country:US
Mailing Address - Phone:414-351-0033
Mailing Address - Fax:
Practice Address - Street 1:8025 N RIVER RD
Practice Address - Street 2:
Practice Address - City:RIVER HILLS
Practice Address - State:WI
Practice Address - Zip Code:53217-2542
Practice Address - Country:US
Practice Address - Phone:414-351-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15197207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ063137Medicaid
AZ063137Medicaid
AZ107711Medicare ID - Type UnspecifiedMARICOPA