Provider Demographics
NPI:1306852694
Name:FRIEDMAN, JARED A (MD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:A
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 1:1325 S CLIFF AVE
Mailing Address - Street 2:ATTN: PT FINANCIAL SERVICES
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1007
Mailing Address - Country:US
Mailing Address - Phone:605-322-6400
Mailing Address - Fax:605-322-6499
Practice Address - Street 1:1325 S CLIFF AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1007
Practice Address - Country:US
Practice Address - Phone:605-322-2000
Practice Address - Fax:605-322-2036
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5669207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE46022474331Medicaid
MN304P4FROtherMN BC PROVIDER #
SC4994391OtherSD BC PROVIDER #
SD5669OtherDAKOTACARE
SD6631220Medicaid
IA0599662Medicaid
MN460104100Medicaid
SDS100565Medicare PIN
SD6631220Medicaid
MN304P4FROtherMN BC PROVIDER #
IA0599662Medicaid