Provider Demographics
NPI:1932181849
Name:FRIEDMAN, MARK NORMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:NORMAN
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:8 RICHLAND MEDICAL PARK DR STE 420
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8004
Practice Address - Country:US
Practice Address - Phone:803-434-8050
Practice Address - Fax:803-933-3005
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2023-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP608202702084N0400X
ND150292084N0400X
NY2933432084N0400X
TXTM007412084N0400X
MI51010237362084N0400X
ARE-158922084N0400X
FLOS84512084N0400X
NJ25MB058066002084N0400X
GA793472084N0400X
MS257592084N0400X
SC520032084N0400X
AZ0074482084N0400X
TN35172084N0400X
OH34.0098032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC520038Medicaid
NJ0122521Medicaid
NJ0122521Medicaid