Provider Demographics
NPI:1275028490
Name:FRIEDLANDER, MAX (DO)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:FRIEDLANDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-479-5327
Mailing Address - Fax:419-479-5593
Practice Address - Street 1:702 COMMERCE DR STE 160
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5272
Practice Address - Country:US
Practice Address - Phone:419-872-7600
Practice Address - Fax:419-872-7601
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.015791207QS0010X, 207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0496749Medicaid