Healthcare Provider Details

I. General information

NPI: 1609972322
Provider Name (Legal Business Name): HOWARD STEPHEN FELDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 W HIGHWAY 89A SUITE 102
COTTONWOOD AZ
86326-3754
US

IV. Provider business mailing address

294 W HIGHWAY 89A SUITE 102
COTTONWOOD AZ
86326-3754
US

V. Phone/Fax

Practice location:
  • Phone: 928-649-7990
  • Fax: 928-649-7989
Mailing address:
  • Phone: 928-649-7990
  • Fax: 928-649-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number11372
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: