Provider Demographics
NPI:1275520678
Name:FRIED, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:FRIED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:1598 S COUNTY TRL STE 201
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1762
Practice Address - Country:US
Practice Address - Phone:401-884-0333
Practice Address - Fax:401-884-0096
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07840207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI110110684OtherRAILROAD MEDICARE
RI2401-5OtherBLUE CHIP
RI710062001OtherCIGNA
RI61162OtherHARVARD HEALTH PLAN
RI04-00503OtherUNITED HEALTH CARE
RI4088OtherNEIGHBORHOOD HEALTH PLAN
RI7002591Medicaid
RI2401OtherBCBS OF RI
RI3589956OtherAETNA
RI709003943OtherMEDICARE GROUP
RI404450OtherTUFTS HEALTH PLAN
RI12119981OtherMULTIPLAN
RI050483739OtherGREAT WEST HEALTH CARE
RI61162OtherHARVARD HEALTH PLAN
RI4088OtherNEIGHBORHOOD HEALTH PLAN
RI7002591Medicaid