Provider Demographics
NPI:1316975261
Name:FRIEDMAN, MARC NISSAN (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:NISSAN
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 TURNEY RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2503
Mailing Address - Country:US
Mailing Address - Phone:216-429-9700
Mailing Address - Fax:216-429-9701
Practice Address - Street 1:5004 TURNEY RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2503
Practice Address - Country:US
Practice Address - Phone:216-429-9700
Practice Address - Fax:216-429-9701
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2156054Medicaid
U80383Medicare UPIN
OH2156054Medicaid