Provider Demographics
NPI:1194733345
Name:FRIEDBERG, DAVID ZACHARY (MD SC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ZACHARY
Last Name:FRIEDBERG
Suffix:
Gender:M
Credentials:MD SC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 88344
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53288-0001
Mailing Address - Country:US
Mailing Address - Phone:414-266-2080
Mailing Address - Fax:414-266-7638
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:STE 401
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3518
Practice Address - Country:US
Practice Address - Phone:414-266-2080
Practice Address - Fax:414-266-7638
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI172162080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30898400Medicaid
WI30898400Medicaid