Provider Demographics
NPI:1346440286
Name:FELDMAN, MARY FISHER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FISHER
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N-839 DOAN HALL 410 WEST 10TH AVE.
Mailing Address - Street 2:OSU THORACIC SURGERY
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1240
Mailing Address - Country:US
Mailing Address - Phone:614-293-4509
Mailing Address - Fax:
Practice Address - Street 1:N-839 DOAN HALL 410 WEST 10TH AVE.
Practice Address - Street 2:OSU THORACIC SURGERY
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-4509
Practice Address - Fax:614-293-0201
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2218363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHR55646Medicare UPIN
OHPA 24241Medicare PIN