Provider Demographics
NPI:1285956987
Name:FRIEDMANN, KARL R (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:R
Last Name:FRIEDMANN
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 1:40 COULT LANE
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371
Mailing Address - Country:US
Mailing Address - Phone:860-434-2783
Mailing Address - Fax:860-434-2332
Practice Address - Street 1:40 COULT LANE
Practice Address - Street 2:
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371
Practice Address - Country:US
Practice Address - Phone:860-434-2783
Practice Address - Fax:860-434-2783
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010369207Q00000X
VT2409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine