Provider Demographics
NPI:1851275341
Name:FRIEND, MICHAEL JR
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FRIEND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15461-1659
Mailing Address - Country:US
Mailing Address - Phone:724-434-9922
Mailing Address - Fax:724-434-9922
Practice Address - Street 1:2614 MEMORIAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1405
Practice Address - Country:US
Practice Address - Phone:724-434-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP033539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily