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General NPI Number Information
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NPI Number | 1932285418
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Entity Type | Individual
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Provider Name | CHARLES STEVEN FEHLAUER MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2773 E ETIENNE WAY
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City | SANDY
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State | UT
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Zip | 84093-1116
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Country | US
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Telephone | 801-272-0255
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Fax | 801-272-0183
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Provider Business Mailing Address
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Address Line | 2773 E ETIENNE WAY
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City | SANDY
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State | UT
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Zip | 84093-1116
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Country | US
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Telephone | 801-824-2748
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Fax | 801-272-4983
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 177543-1205
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License Number State | UT
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