Provider Demographics
NPI:1861689788
Name:FRIEDMAN, CHERRYL GRITZBAUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERRYL
Middle Name:GRITZBAUGH
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WESLEY CIR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9077
Mailing Address - Country:US
Mailing Address - Phone:317-877-1547
Mailing Address - Fax:317-877-1547
Practice Address - Street 1:119 WESLEY CIR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-9077
Practice Address - Country:US
Practice Address - Phone:317-877-1547
Practice Address - Fax:317-877-1547
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027047A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND69534Medicare UPIN