Basic Information
Provider Information
NPI: 1861570392
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDLAND
FirstName: STEVEN
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3003 N CENTRAL AVE STE 400
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122929
CountryCode: US
TelephoneNumber: 6026856000
FaxNumber: 6023027925
Practice Location
Address1: 1111 S STAPLEY DR
Address2:  
City: MESA
State: AZ
PostalCode: 852045059
CountryCode: US
TelephoneNumber: 6026856000
FaxNumber: 4808345703
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 08/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804X23767AZY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

ID Information
IDTypeStateIssuerDescription
43347505AZ MEDICAID


Home