Basic Information
| Provider Information | |||||||||
| NPI: | 1952487134 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | MOLLY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 92997 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441942997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304252212 | ||||||||
| FaxNumber: | 3304252779 | ||||||||
| Practice Location | |||||||||
| Address1: | 8900 DARROW RD STE H112 | ||||||||
| Address2: | |||||||||
| City: | TWINSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440876802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304252212 | ||||||||
| FaxNumber: | 3304252779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2006 | ||||||||
| LastUpdateDate: | 12/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 34006571F | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.