Provider Demographics
NPI:1376591016
Name:FELDER, RALPH C (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:C
Last Name:FELDER
Suffix:
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 1:1840 W APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-3728
Mailing Address - Country:US
Mailing Address - Phone:480-889-3500
Mailing Address - Fax:480-889-3502
Practice Address - Street 1:1840 W APACHE TRL
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85220-3728
Practice Address - Country:US
Practice Address - Phone:480-889-3500
Practice Address - Fax:480-889-3502
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15719174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ251760Medicaid
AZUPIN E52323Medicare ID - Type Unspecified