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Individual

DR. AMY LYN FRIEDENTHAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
125120 D LAKERIDGE DRIVE, WOODBRIDGE, VA 22192
(703) 497-5555
(703) 497-1479
Mailing address
125120 D LAKERIDGE DRIVE, WOODBRIDGE, VA 22192
(703) 497-5555
(703) 684-6311

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101047502
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004666397
AETNA
VA
05
010031427
VA
01
267008
BLUE CROSS - ANTHEM
VA
Enumeration date
03/26/2007
Last updated
06/25/2010
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