Basic Information
| Provider Information | |||||||||
| NPI: | 1083750509 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIEDER | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5712 N PLACITA ARIZPE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857184638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059199661 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3390 N. CAMPBELL AVE. | ||||||||
| Address2: | SUITE #110 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857192380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207957650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 12/04/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 006358 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 208D00000X | 200300978 | NC | N | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.