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General NPI Number Information
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NPI Number | 1962425223
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Entity Type | Individual
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Provider Name | IRA L FEDDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 7505 OSLER DR SUITE 104
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City | TOWSON
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State | MD
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Zip | 21204-7736
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Country | US
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Telephone | 410-337-8888
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Fax | 410-823-4833
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Provider Business Mailing Address
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Address Line | 7505 OSLER DR SUITE 104
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City | TOWSON
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State | MD
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Zip | 21204-7736
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Country | US
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Telephone | 410-337-8888
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Fax | 410-823-4833
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | D0037294
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License Number State | MD
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