Provider Demographics
NPI:1740302090
Name:FRIEDLAND, GARY A (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:A
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 1:2005 FRANKLIN ST
Mailing Address - Street 2:MIDTOWN 2, SUITE 390
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5401
Mailing Address - Country:US
Mailing Address - Phone:303-318-2250
Mailing Address - Fax:303-318-2252
Practice Address - Street 1:2005 FRANKLIN ST
Practice Address - Street 2:MIDTOWN 2, SUITE 390
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-318-2250
Practice Address - Fax:303-318-2252
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13613207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01136134Medicaid
P00101122OtherMEDICARE RAILROAD
COC163148Medicare PIN
D22464Medicare UPIN