Provider Demographics
NPI:1104937853
Name:FRIEDMAN, WILLIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W OSBORN RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3814
Mailing Address - Country:US
Mailing Address - Phone:602-264-1031
Mailing Address - Fax:602-264-3864
Practice Address - Street 1:444 W OSBORN RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3814
Practice Address - Country:US
Practice Address - Phone:602-264-1031
Practice Address - Fax:602-264-3864
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0050213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0737160001OtherNORIDIAN DME
AZ700428Medicaid
AZAZ0065310OtherBCBS OF ARIZONA
AZT41624Medicare UPIN
AZZ64506Medicare ID - Type Unspecified