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NPI Code Detail

MEDICARE: MARK A FELDNER MD

MEDICARE:   MARK A FELDNER  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
1207Q00000XFamily Medicine Physician01035622AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3080179938OTHERINMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000081296OTHERINANTHEM BCBS

General Provider Information

NPI Number : 1952300873
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A FELDNER MD
Provider Business Mailing Address
First Line : 9660 WICKER AVE
Second Line :
City : ST JOHN
State : IN
Zip : 46373-9487
Country : US
Telephone Number : 219-365-1166
Fax Number : 219-365-8852
Provider Business Practice Location Address
First Line : 9660 WICKER AVE
Second Line :
City : ST JOHN
State : IN
Zip : 46373-9487
Country : US
Telephone Number : 219-365-1166
Fax Number : 219-365-8852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 06/17/2010

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Directions to “ MARK A FELDNER MD” Practice Location

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