Provider Demographics
NPI:1952508467
Name:FRIEDMAN, STEPHEN SIMON (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SIMON
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1931
Mailing Address - Country:US
Mailing Address - Phone:248-738-5952
Mailing Address - Fax:248-683-8039
Practice Address - Street 1:2960 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-1931
Practice Address - Country:US
Practice Address - Phone:248-738-5952
Practice Address - Fax:248-683-8039
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101004669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine