Provider Demographics
NPI:1740208214
Name:FRIEDLAND, ROBERT P (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:FRIEDLAND
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:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 E CHESTNUT ST.
Practice Address - Street 2:SUITE 510
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-588-4800
Practice Address - Fax:502-588-4801
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY425552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100073760Medicaid
KYP00753164OtherRR MEDICARE
IN200936130Medicaid