Fried, Martin B

Fried, Martin B is an individual health care provider with primary practice located at 490 Northampton St Gateway Suite 1, Edwardsville PA 18704-4551. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Fried, Martin B can be contacted via phone (570) 288-8100.

Contact Information

Primary practice address
490 Northampton St Gateway Suite 1 Edwardsville PA 18704-4551
Phone: (570) 288-8100
Fax: (570) 288-7987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD020746E Pennsylvania

Profile Details

NPI number 1205894862
LBN Legal business name Fried, Martin B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Aug 31st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205894862 NPPES
Pennsylvania Other 027970 MEDICARE PROVIDER #

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