Provider Demographics
NPI:1205899887
Name:FRIEDMAN, ROGER LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:LEE
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 MEADOW LANE CT
Mailing Address - Street 2:SUITE 22
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-0600
Mailing Address - Country:US
Mailing Address - Phone:440-934-8444
Mailing Address - Fax:440-934-8447
Practice Address - Street 1:5321 MEADOW LANE CT
Practice Address - Street 2:SUITE 22
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-0600
Practice Address - Country:US
Practice Address - Phone:440-934-8444
Practice Address - Fax:440-934-8447
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002311213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1750564845OtherORGANIZATIONAL NPI
OH4777020001Medicare NSC
OH1750564845OtherORGANIZATIONAL NPI