MEDICARE: DR. PAUL CHARLES FEINBERG O.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
1	152W00000X	Optometrist	4901001776	MI

General Provider Information

NPI Number	:	1114063856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL CHARLES FEINBERG O.D.

Provider Business Mailing Address
First Line	:	2550 S TELEGRAPH RD STE 100
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0951
Country	:	US
Telephone Number	:	248-258-9000
Fax Number	:	248-499-6372

Provider Business Practice Location Address
First Line	:	2550 S TELEGRAPH RD STE 100
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0951
Country	:	US
Telephone Number	:	248-258-9000
Fax Number	:	248-499-6372

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	04/18/2013

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