Individual
GORDON W FRIED
Active
Individual
GORDON W FRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS-007213-E
PA
207RI0011X
Interventional Cardiology Physician
Primary
OS007213E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012090750005
—
PA
01
—
0457628
AETNA
PA
01
—
075227
1ST PRIORITY
PA
01
—
2101332
GHI
PA
01
—
232725862
ALL OTHER INS
PA
Enumeration date
07/07/2005
Last updated
04/29/2009
Update your record
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