Provider Demographics
NPI:1275531543
Name:FRIEDMAN, GREGG LOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:LOWELL
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 1:2500 EAST HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 702
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4840
Mailing Address - Country:US
Mailing Address - Phone:954-456-1996
Mailing Address - Fax:
Practice Address - Street 1:2500 EAST HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 702
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4840
Practice Address - Country:US
Practice Address - Phone:954-456-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME494472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry