MEDICARE: CASEY J FEHER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	10000839A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	351984674	OTHER	IN	CURRENT TAX ID

General Provider Information

NPI Number	:	1003861717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY J FEHER PA

Provider Business Mailing Address
First Line	:	7340 SHADELAND STA STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3980
Country	:	US
Telephone Number	:	317-806-8260
Fax Number	:	317-806-8296

Provider Business Practice Location Address
First Line	:	7340 SHADELAND STA STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3980
Country	:	US
Telephone Number	:	317-806-8260
Fax Number	:	317-806-8296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	08/16/2012

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Directions to “ CASEY J FEHER PA” Practice Location

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