Provider Demographics
NPI:1033246749
Name:FELD, DAVID WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WARD
Last Name:FELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JUPITER LAKES BLVD STE 4101
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7190
Mailing Address - Country:US
Mailing Address - Phone:561-747-3777
Mailing Address - Fax:561-746-4720
Practice Address - Street 1:210 JUPITER LAKES BLVD STE 4101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7190
Practice Address - Country:US
Practice Address - Phone:561-747-3777
Practice Address - Fax:561-746-4720
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32414174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50854Medicare ID - Type Unspecified
FLD-55867Medicare UPIN