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General NPI Number Information
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NPI Number | 1689690216
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Entity Type | Individual
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Provider Name | MICHAEL J FELTES M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 3 HERON RD
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City | MYSTIC
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State | CT
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Zip | 06355-3253
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Country | US
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Telephone | 860-536-6442
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Fax | 860-536-6442
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Provider Business Mailing Address
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Address Line | 819 WORCESTER ST SUITE 3
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City | SPRINGFIELD
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State | MA
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Zip | 01151-1045
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Country | US
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Telephone | 413-543-6820
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Fax | 413-543-7962
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 029513
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 029513
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 029513
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License Number State | CT
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