Provider Demographics
NPI:1518052869
Name:FRIEDMAN, KENNETH S (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:S
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6512 GARDENWICK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2538
Mailing Address - Country:US
Mailing Address - Phone:410-790-1906
Mailing Address - Fax:410-663-4468
Practice Address - Street 1:6512 GARDENWICK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2538
Practice Address - Country:US
Practice Address - Phone:410-790-1906
Practice Address - Fax:410-663-4468
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor