Provider Demographics
NPI:1588766190
Name:FRIEDMAN, MATTHEW JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOEL
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2326 COX DISTRICT RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-9529
Mailing Address - Country:US
Mailing Address - Phone:802-457-3794
Mailing Address - Fax:
Practice Address - Street 1:V A MEDICAL CTR
Practice Address - Street 2:215 NORTH MAIN STREET
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-296-5132
Practice Address - Fax:802-296-5135
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00049812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry