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1720063175

NPI Code Detail

MEDICARE: STEVEN RICHARD FELDMAN MD

MEDICARE: STEVEN RICHARD 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	207N00000X	Dermatology Physician	31811	NC
2	207ND0900X	Dermatopathology Physician	31811	NC
3	207NS0135X	Procedural Dermatology Physician	31811	NC

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	31516	OTHER		BCBS
3	63997	OTHER		MEDCOST
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4514	OTHER		PARTNERS
7	5869085	OTHER		AETNA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720063175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN RICHARD FELDMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 602658
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2658
Country	:	US
Telephone Number	:	336-716-2011
Fax Number	:

Provider Business Practice Location Address
First Line	:	4618 COUNTRY CLUB RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27104-3520
Country	:	US
Telephone Number	:	336-716-3926
Fax Number	:	336-716-9258

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	07/28/2015

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Directions to “ STEVEN RICHARD FELDMAN MD” Practice Location

Language	Start Address	Practice Location

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