Doctor Name: | KEVIN JACOB FRIEDMAN |
NPI Number: | 1407951346 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 0102201906 |
Business Practice Address: | National Naval Medical Ctr 8901 Wisconsin Avenue Bethesda, MD - 208895600 |
Business Phone Number: | 3017856077 |
Business Fax Number: | |
Mailing Address: | 11635 Sw 135th Pl, MIAMI |
State: | FL |
Postal Code: | 331864429 |
Phone Number: | 3017856077 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0102201906 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |