Provider Demographics
NPI:1619932787
Name:FRIEDMAN, CARL SETH (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:SETH
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1324
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:515 FAIRMOUNT AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-494-1322
Practice Address - Fax:410-494-1670
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0020688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD976211600Medicaid
MD976211600Medicaid
MD157676Medicare PIN
MDD78222Medicare UPIN
MDH596V202Medicare PIN
157811ZR0ZMedicare PIN