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General NPI Number Information
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NPI Number | 1891649521
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Entity Type | Organization
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Legal Business Name | FEDERMAN WELLCARE, LLC
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 3425 EXECUTIVE PKWY STE 117
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City | TOLEDO
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State | OH
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Zip | 43606-1333
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Country | US
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Telephone | 419-469-2102
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Fax | 419-214-5850
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Provider Business Mailing Address
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Address Line | 3425 EXECUTIVE PKWY STE 117
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City | TOLEDO
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State | OH
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Zip | 43606-1333
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Country | US
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Telephone |
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Fax | 419-214-5850
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Authorized Official
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Title or Position | PHYSICIAN-OWNER
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Name | SUSAN MICHELLE FEDERMAN
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Credential | MD
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Telephone | 419-469-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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