Provider Demographics
NPI:1457421588
Name:FREIDLY, JOYCE M (PA-C)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:FREIDLY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10200 GRAND CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3333 N CALVERT ST STE 600
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6504
Practice Address - Country:US
Practice Address - Phone:410-467-7665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003422363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ74361Medicare UPIN
MDS806O926Medicare PIN