MEDICARE: DR. MARK BENNETT FEINBERG MD, PHD

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	207R00000X	Internal Medicine Physician	G73726	CA

General Provider Information

NPI Number	:	1851019236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK BENNETT FEINBERG MD, PHD

Provider Business Mailing Address
First Line	:	1020 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3715
Country	:	US
Telephone Number	:	215-435-6981
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3715
Country	:	US
Telephone Number	:	215-435-6981
Fax Number	:

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

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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