MEDICARE: WILLIAM FELDMANN

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	183500000X	Pharmacist	8454	SC

General Provider Information

NPI Number	:	1487256533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM FELDMANN

Provider Business Mailing Address
First Line	:	307 74TH AVE N APT 1A
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-3837
Country	:	US
Telephone Number	:	704-649-4763
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 74TH AVE N APT 1A
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-3837
Country	:	US
Telephone Number	:	704-649-4763
Fax Number	:

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

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	11/13/2020

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