MEDICARE: DR. CHERYL G FEKETE M.D.

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	208000000X	Pediatrics Physician	21595	AL

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
2	F944	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1457357311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL G FEKETE M.D.

Provider Business Mailing Address
First Line	:	470 TAYLOR RD
Second Line	:	SUITE 210
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-3563
Country	:	US
Telephone Number	:	334-293-5033
Fax Number	:	334-293-5024

Provider Business Practice Location Address
First Line	:	470 TAYLOR RD
Second Line	:	SUITE 210
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-3563
Country	:	US
Telephone Number	:	334-293-5033
Fax Number	:	334-293-5024

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/03/2015

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