Provider Demographics
NPI:1699756148
Name:FRIEDEL, JEFFREY M (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:FRIEDEL
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 1:1050 BOWER HILL RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1800
Mailing Address - Country:US
Mailing Address - Phone:412-344-4767
Mailing Address - Fax:412-344-0405
Practice Address - Street 1:1050 BOWER HILL RD
Practice Address - Street 2:SUITE 308
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1800
Practice Address - Country:US
Practice Address - Phone:412-344-4767
Practice Address - Fax:412-344-0405
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD069122L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000163158OtherUNISON HEALTH PLAN
PA0018507170001Medicaid
P00225458OtherRAILROAD MEDICARE
1007268OtherGATEWAY HEALTH PLAN
PA959210OtherHIGHMARK BLUE SHIELD
PA959210OtherHIGHMARK BLUE SHIELD
P00225458OtherRAILROAD MEDICARE