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NPI Code Detail

MEDICARE: EVAN FEICHTER

MEDICARE: EVAN FEICHTER
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
11223G0001XGeneral Practice Dentistry12013634AIN

General Provider Information

NPI Number : 1548837008
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN FEICHTER
Provider Business Mailing Address
First Line : 6412 WINCHESTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46819-1550
Country : US
Telephone Number : 260-747-4747
Fax Number :
Provider Business Practice Location Address
First Line : 6412 WINCHESTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46819-1550
Country : US
Telephone Number : 269-747-4747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2021
Last Update Date : 06/04/2021

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Directions to “ EVAN FEICHTER ” Practice Location

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