Healthcare Provider Details

I. General information

NPI: 1598727992
Provider Name (Legal Business Name): DR. CARY S FELDMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 OAKWOOD DR SUITE 202
ROCHESTER MI
48307-1360
US

IV. Provider business mailing address

811 OAKWOOD DR SUITE 202
ROCHESTER MI
48307-1360
US

V. Phone/Fax

Practice location:
  • Phone: 734-459-7444
  • Fax: 734-459-7755
Mailing address:
  • Phone: 734-459-7444
  • Fax: 734-459-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberCF044972
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: