Provider Demographics
NPI:1134110885
Name:REMCHUK FEUER, STACEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:L
Last Name:REMCHUK FEUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:L
Other - Last Name:REMCHUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 41150
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-1150
Mailing Address - Country:US
Mailing Address - Phone:480-425-2160
Mailing Address - Fax:480-351-8797
Practice Address - Street 1:2421 E SOUTHERN AVE STE 7
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7612
Practice Address - Country:US
Practice Address - Phone:480-425-2160
Practice Address - Fax:480-351-8797
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35036207L00000X, 207L00000X
MA223521207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ104032Medicaid
P00444515OtherMEDICARE RAILROAD
P00444515OtherMEDICARE RAILROAD
MAJ29243OtherBCBS MA
MA478742OtherTUFTS HEALTH PLAN
I39826Medicare UPIN
AZZ110618Medicare PIN