Provider Demographics
NPI:1265409908
Name:FRIED, MICHAEL DAVID (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:FRIED
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 1:120 CONNER DRIVE
Mailing Address - Street 2:#101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-942-8571
Mailing Address - Fax:919-942-6355
Practice Address - Street 1:120 CONNER DR
Practice Address - Street 2:#101 CHAPEL HILL OB GYN
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-942-8571
Practice Address - Fax:919-942-6355
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18319207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC154771OtherWELLPATH
NC33926OtherBCBS
NC562142486OtherBEECHSTREET
NC12484198002OtherUHC
NC23980OtherMEDCOST
NC7933926Medicaid
NC801640OtherCIGNA
NC33926OtherBCBS
206436Medicare ID - Type Unspecified