Individual
WALTER JONATHAN FRIEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 DELAWARE AVENEUE, MARION, OH 43301-1814
(740) 383-8090
(740) 375-6481
Mailing address
L-3549, COLUMBUS, OH 43260-0001
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.079367
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202163
ANTHEM
—
01
—
1202702
UHC
—
05
—
2244360
—
OH
01
—
311090079
CIGNA
—
01
—
311098079
TAX ID
—
01
—
353077
SUBMITTER NO
—
01
—
370018677
TRAVELERS MEDICARE
—
01
—
7052274
AETNA
—
Enumeration date
05/03/2006
Last updated
12/21/2021
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