MEDICARE: VICKY FIEDLER 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	2080N0001X	Neonatal-Perinatal Medicine Physician	25MA04144000	NJ

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881673903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKY FIEDLER MD

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:	PROVIDER ENROLLMENT DEPARTMENT
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-6212
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 WEST SHERMAN AVENUE
Second Line	:	INSPIRA MEDICAL CENTER VINELAND
City	:	VINELAND
State	:	NJ
Zip	:	08060
Country	:	US
Telephone Number	:	856-651-4945
Fax Number	:

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	09/17/2014

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