Healthcare Provider Details

I. General information

NPI: 1629036728
Provider Name (Legal Business Name): RAYMOND V FEEHERY JR. DPM, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 STANTON CHRISTIANA RD SUITE 303
NEWARK DE
19713-2133
US

IV. Provider business mailing address

620 STANTON CHRISTIANA RD SUITE 303
NEWARK DE
19713-2133
US

V. Phone/Fax

Practice location:
  • Phone: 302-999-8511
  • Fax: 302-999-8645
Mailing address:
  • Phone: 302-999-8511
  • Fax: 302-999-8645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberEL-0000075
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberEL-0000075
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: