MEDICARE: MARK R FELDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	37989	IA
2	207V00000X	Obstetrics & Gynecology Physician	01050576A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255325718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK R FELDMAN MD

Provider Business Mailing Address
First Line	:	2551 S SMITH RD
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-8943
Country	:	US
Telephone Number	:	812-277-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 S SMITH RD
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-8943
Country	:	US
Telephone Number	:	812-277-5311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	10/26/2015

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Directions to “ MARK R FELDMAN MD” Practice Location

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