Provider Demographics
NPI:1275618498
Name:FELBER, KARL (DO)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:FELBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ARMISTICE BLVD
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-725-4100
Mailing Address - Fax:401-728-5010
Practice Address - Street 1:209 ARMISTICE BLVD
Practice Address - Street 2:PAWTUCKET HEALTHCARE INC
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-725-4100
Practice Address - Fax:401-728-5010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RID000412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002861Medicaid
RI7002861Medicaid