Healthcare Provider Details

I. General information

NPI: 1083682637
Provider Name (Legal Business Name): LOUIS S FELDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 LIBERTY AVE STE 102
PITTSBURGH PA
15224-2215
US

IV. Provider business mailing address

5140 LIBERTY AVE STE 102
PITTSBURGH PA
15224-2215
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-2300
  • Fax: 412-681-6959
Mailing address:
  • Phone: 412-681-2300
  • Fax: 412-681-6959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number30156
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD050918L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: