Provider Demographics
NPI:1205994530
Name:FRIEDMAN, AMBER MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-0066
Mailing Address - Fax:614-293-7264
Practice Address - Street 1:1145 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3117
Practice Address - Country:US
Practice Address - Phone:614-293-0066
Practice Address - Fax:614-293-7264
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5845133V00000X
OH003419363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50.003419RXOtherOHIO STATE LICENSE
OH5717373OtherAETNA
OH000000490878OtherANTHEM
OH4155197OtherCIGNA
OH0087086Medicaid