MEDICARE: CHARLES STEVEN FEHLAUER 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	177543-1205	UT

General Provider Information

NPI Number	:	1932285418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES STEVEN FEHLAUER MD

Provider Business Mailing Address
First Line	:	2773 E ETIENNE WAY
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-1116
Country	:	US
Telephone Number	:	801-824-2748
Fax Number	:	801-272-4983

Provider Business Practice Location Address
First Line	:	2773 E ETIENNE WAY
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-1116
Country	:	US
Telephone Number	:	801-272-0255
Fax Number	:	801-272-0183

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	12/12/2025

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