Individual
DR. MARIANNE FOTIADIS FRIDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
510 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3318
(410) 939-5330
(410) 939-6204
Mailing address
PO BOX 337, HAVRE DE GRACE, MD 21078-0337
(410) 939-9442
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D22433
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377684
FIRST HEALTH
MD
01
—
2809440371
COVENTRY
MD
01
—
4283566
AETNA PPO
MD
01
—
817508
MAMSI
MD
01
—
897793
AETNA HMO
MD
01
—
S951
BLUECROSS/BLUESHIELD
MD
01
—
T7960001
CAREFIRST BLUECHOICE
MD
Enumeration date
07/17/2006
Last updated
07/08/2007
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