Provider Demographics
NPI:1962470435
Name:FRIEDL, HAROLD D (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:D
Last Name:FRIEDL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1126 GULL ROAD
Mailing Address - Street 2:COLON AND RECTAL SURGERY ASSOCIATES PC
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1726
Mailing Address - Country:US
Mailing Address - Phone:269-343-0740
Mailing Address - Fax:269-343-0715
Practice Address - Street 1:1126 GULL ROAD
Practice Address - Street 2:COLON AND RECTAL SURGERY ASSOCIATES PC
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1726
Practice Address - Country:US
Practice Address - Phone:269-343-0740
Practice Address - Fax:269-343-0715
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2008-01-11
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Provider Licenses
StateLicense IDTaxonomies
MI4301036711208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1025761770Medicaid
MI280C96122OtherBCBS MICHIGAN
MI280C96122OtherBCBS MICHIGAN
MI1025761770Medicaid