Healthcare Provider Details

I. General information

NPI: 1760915482
Provider Name (Legal Business Name): PALMER S FEIBELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE
BETHESDA MD
20889-5669
US

IV. Provider business mailing address

1 SAN DIEGO LOOP BLDG 3282
JB ANDREWS MD
20762-5518
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-9283
  • Fax:
Mailing address:
  • Phone: 240-857-5504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number31131
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: