MEDICARE: INGRID HAFENSCHER FEDER 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	207Q00000X	Family Medicine Physician	MD12773	RI

General Provider Information

NPI Number	:	1609872845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID HAFENSCHER FEDER MD

Provider Business Mailing Address
First Line	:	PO BOX 229
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02880-0229
Country	:	US
Telephone Number	:	401-788-3929
Fax Number	:	401-788-3939

Provider Business Practice Location Address
First Line	:	100 KENYON AVE
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4216
Country	:	US
Telephone Number	:	401-788-1590
Fax Number	:	401-788-1593

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	03/17/2026

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