1558334193 NPI number — DR. ROBERT FELDMAN DPM

Table of content: DR. ROBERT FELDMAN DPM (NPI 1558334193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558334193 NPI number — DR. ROBERT FELDMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELDMAN
Provider First Name:
ROBERT
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558334193
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
876 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24523-2904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-587-6963
Provider Business Mailing Address Fax Number:
540-587-6962

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
876 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24523-2904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-587-6963
Provider Business Practice Location Address Fax Number:
540-587-6962
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  0103000619 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 176821 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 650167090 . This is a "PIEDMONT COMMUNITY HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: UNION BANKERS INS . This is a "650167090" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 009301691 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 240479 . This is a "TRIGON BLUE CROSS BLUE SH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010291054 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22545 . This is a "VA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 480020055 . This is a "RR MCR OLD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00403819 . This is a "RR MCR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 240479 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 650167090-24523-0000 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 650167090 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 13825 . This is a "PARTNERS NATIONAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 296673 . This is a "BCBS NEW" identifier . This identifiers is of the category "OTHER".




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