Provider Demographics
NPI:1932198280
Name:FRIEDMAN, ERIC S (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:S
Last Name:FRIEDMAN
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 1:14100 PARKWAY COMMONS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6036
Mailing Address - Country:US
Mailing Address - Phone:405-748-3300
Mailing Address - Fax:405-748-2920
Practice Address - Street 1:14100 PARKWAY COMMONS DR STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6036
Practice Address - Country:US
Practice Address - Phone:405-748-3300
Practice Address - Fax:405-748-2920
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17070174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100012950AMedicaid
F23502Medicare UPIN
244419612Medicare PIN