Healthcare Provider Details

I. General information

NPI: 1457925208
Provider Name (Legal Business Name): GEORGE FELEMEGOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N JAMES ST
ROME NY
13440-2844
US

IV. Provider business mailing address

16001 WEST 9 MILE ROAD, 4 FISCHER ROOM 405
SOUTHFIELD MI
48075
US

V. Phone/Fax

Practice location:
  • Phone: 315-338-7000
  • Fax:
Mailing address:
  • Phone: 247-849-3151
  • Fax: 248-849-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351049442
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: