Healthcare Provider Details
I. General information
NPI: 1093759797
Provider Name (Legal Business Name): MATTHEW D. FELBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/15/2006
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
958 WELLNESS WAY STE 1
PENDER NE
68047-4518
US
IV. Provider business mailing address
PO BOX 100
PENDER NE
68047-0100
US
V. Phone/Fax
- Phone: 402-385-3033
- Fax: 402-385-3092
- Phone: 402-385-4004
- Fax: 402-385-4041
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 1122 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: