MEDICARE: DR. MICHAEL WILLIAM FIEDLER 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	207L00000X	Anesthesiology Physician	G73536	CA

General Provider Information

NPI Number	:	1861630782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WILLIAM FIEDLER M.D.

Provider Business Mailing Address
First Line	:	848 N RAINBOW BLVD
Second Line	:	696
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1103
Country	:	US
Telephone Number	:	310-849-0628
Fax Number	:

Provider Business Practice Location Address
First Line	:	848 N RAINBOW BLVD
Second Line	:	696
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1103
Country	:	US
Telephone Number	:	310-849-0628
Fax Number	:

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

Provider Enumeration Date	:	01/30/2009
Last Update Date	:	01/30/2009

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