Provider Demographics
NPI:1598892838
Name:FRIEDMAN, WILLIAM H (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
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 1:3023 N BALLAS RD
Mailing Address - Street 2:SUITE 600D
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2330
Mailing Address - Country:US
Mailing Address - Phone:314-991-4644
Mailing Address - Fax:
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:SUITE 600D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-991-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO29636207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA29076Medicare UPIN