Provider Demographics
NPI:1013919182
Name:FRIEDLAND, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
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 1:49 HOOPER ST.
Mailing Address - Street 2:MILES FAMILY MEDICINE - WISCASSET
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578
Mailing Address - Country:US
Mailing Address - Phone:207-882-7911
Mailing Address - Fax:207-882-6178
Practice Address - Street 1:49 HOOPER ST.
Practice Address - Street 2:MILES FAMILY MEDICINE - WISCASSET
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578
Practice Address - Country:US
Practice Address - Phone:207-882-7911
Practice Address - Fax:207-882-6178
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME333870099Medicaid
MEM84911/M94970OtherHEALTHSOURCE
ME047672OtherANTHEM BC BS
ME333870099/101980000Medicaid
MESX2745Medicare PIN
MEMM5575/MM8304Medicare ID - Type UnspecifiedMEDICARE
ME333870099/101980000Medicaid