Individual
DR. MARK A. FRIDOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
14 AULIKE ST, PH 2, KAILUA, HI 96734-2740
(808) 236-8237
Mailing address
14 AULIKE ST, PH 2, KAILUA, HI 96734-2740
(808) 236-8237
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2775
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2775
PSYCHOLOGIST
MA
Enumeration date
12/12/2006
Last updated
07/08/2007
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