Provider Demographics
NPI:1033103106
Name:FELLER, DANIEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:FELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18325 N ALLIED WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-3105
Mailing Address - Country:US
Mailing Address - Phone:602-467-4966
Mailing Address - Fax:480-419-5401
Practice Address - Street 1:18325 N ALLIED WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-3105
Practice Address - Country:US
Practice Address - Phone:602-467-4966
Practice Address - Fax:480-419-5401
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2010-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ14206207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ253443Medicaid
AZ253443Medicaid
AZ26651Medicare ID - Type Unspecified