Provider Demographics
NPI:1376541615
Name:FELDER, DAVID A JR (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:FELDER
Suffix:JR
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 1:3703 TEAYS VALLEY RD
Mailing Address - Street 2:TEAYS VALLEY ORTHOPEDICS
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526
Mailing Address - Country:US
Mailing Address - Phone:304-757-2273
Mailing Address - Fax:304-760-9290
Practice Address - Street 1:3703 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9645
Practice Address - Country:US
Practice Address - Phone:304-757-2273
Practice Address - Fax:304-760-9290
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035655207X00000X
WV22661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6447244Medicaid
WV3810007898Medicaid
VAB05822Medicare UPIN
VA2000001080Medicare ID - Type Unspecified
WV3810007898Medicaid
P00874104Medicare PIN