Healthcare Provider Details

I. General information

NPI: 1558334193
Provider Name (Legal Business Name): ROBERT FELDMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 E MAIN ST
BEDFORD VA
24523-2904
US

IV. Provider business mailing address

876 E MAIN ST
BEDFORD VA
24523-2904
US

V. Phone/Fax

Practice location:
  • Phone: 540-587-6963
  • Fax: 540-587-6962
Mailing address:
  • Phone: 540-587-6963
  • Fax: 540-587-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0103000619
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: