Provider Demographics
NPI:1811051303
Name:FRIEDMAN, STUART A (DO)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:A
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-612-4532
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4963
Practice Address - Fax:215-612-4532
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003575L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00701445-04OtherAMERICHOICE-FRANKFORD
PA20037795OtherAMERIHEALTH MERCY
PA5653790OtherCIGNA
PA0007014450009Medicaid
PAPA0028949OtherTRICARE
PA0007014450017Medicaid
PA0062027000OtherKEYSTONE,IBC
PA00701445-02OtherAMERICHOICE-TORRESDALE
PA930010853OtherRAILROAD MEDICARE
PA00701445-03OtherAMERICHOICE-BUCKS DIV
PA07645OtherHEALTH PARTNERS
PA151021OtherHIGHMARK BLUE SHIELD
PA151021OtherPERSONAL CHOICE
PA0007014450011Medicaid
PA1089627OtherKEYSTONE MERCY
PA452729OtherAETNA CONTRACT
PA0007014450017Medicaid
PA452729OtherAETNA CONTRACT