Provider Demographics
NPI:1356434617
Name:DR. HARRY J. DRIEDGER, INC.
Entity type:Organization
Organization Name:DR. HARRY J. DRIEDGER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DRIEDGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-353-7870
Mailing Address - Street 1:1870 COLES BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6900
Mailing Address - Country:US
Mailing Address - Phone:740-353-7870
Mailing Address - Fax:740-353-1531
Practice Address - Street 1:1870 COLES BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6900
Practice Address - Country:US
Practice Address - Phone:740-353-7870
Practice Address - Fax:740-353-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-01
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043229207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty