Provider Demographics
NPI:1912571191
Name:FRIEDL, EMILY ANN (DO)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANN
Last Name:FRIEDL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE # MC188
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-267-0895
Mailing Address - Fax:616-267-0282
Practice Address - Street 1:100 MICHIGAN ST NE # MC188
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2560
Practice Address - Country:US
Practice Address - Phone:616-267-0895
Practice Address - Fax:616-267-0282
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017342208000000X
OH5101028692208M00000X
MI5101028692208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0443964Medicaid