Healthcare Provider Details

I. General information

NPI: 1881075596
Provider Name (Legal Business Name): MARK FEGLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

PO BOX 500
SOUDERTON PA
18964-0500
US

V. Phone/Fax

Practice location:
  • Phone: 866-785-8537
  • Fax:
Mailing address:
  • Phone: 610-954-5810
  • Fax: 610-954-5840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number25MA10835800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMD467603
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD467603
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA10835800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: