Healthcare Provider Details

I. General information

NPI: 1487836045
Provider Name (Legal Business Name): RICHARD FELDMAN, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

9500 ANNAPOLIS RD SUITE A4
LANHAM MD
20706-2060
US

IV. Provider business mailing address

9500 ANNAPOLIS RD SUITE A4
LANHAM MD
20706-2060
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-1588
  • Fax: 410-266-6931
Mailing address:
  • Phone: 410-266-1588
  • Fax: 410-266-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0032261
License Number StateMD

VIII. Authorized Official

Name: RICHARD J FELDMAN
Title or Position: OWNER
Credential: M.D.
Phone: 410-266-1588