Provider Demographics
NPI:1356452247
Name:FEKETE, STEPHEN (DPM)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:FEKETE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29756 SW TOWN CENTER LOOP W STE H
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6482
Mailing Address - Country:US
Mailing Address - Phone:503-682-6035
Mailing Address - Fax:503-582-8485
Practice Address - Street 1:29756 SW TOWN CENTER LOOP W STE H
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6482
Practice Address - Country:US
Practice Address - Phone:503-682-6035
Practice Address - Fax:503-582-8485
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00191213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR001342Medicaid
OR308335500OtherBLUE CROSS BLUE SHIELD
T67602Medicare UPIN
OOOOSGBJXMedicare ID - Type Unspecified