Provider Demographics
NPI:1376597526
Name:BERTRAM E FEINGOLD, MD, LTD
Entity Type:Organization
Organization Name:BERTRAM E FEINGOLD, MD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERTRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-949-9074
Mailing Address - Street 1:3126 N CIVIC CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6912
Mailing Address - Country:US
Mailing Address - Phone:480-949-9074
Mailing Address - Fax:480-949-9871
Practice Address - Street 1:3126 N CIVIC CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6912
Practice Address - Country:US
Practice Address - Phone:480-949-9074
Practice Address - Fax:480-949-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ08752207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1376597526Medicare PIN
AZC99460Medicare UPIN
AZZOOOOBGGGNMedicare UPIN