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NPI Code Detail

MEDICARE: DR. ROBERT FEDER M.D.

MEDICARE: DR. ROBERT FEDER M.D.
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
12084P0800XPsychiatry Physician6710NH

General Provider Information

NPI Number : 1063434439
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT FEDER M.D.
Provider Business Mailing Address
First Line : 753 CHESTNUT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3011
Country : US
Telephone Number : 603-860-2593
Fax Number : 603-624-1884
Provider Business Practice Location Address
First Line : 753 CHESTNUT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3011
Country : US
Telephone Number : 603-860-2593
Fax Number : 603-624-1884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/12/2007

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