Provider Demographics
NPI:1407902018
Name:FELDMAN, ALICIA B (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:B
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 LOCKHEED AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7027
Mailing Address - Country:US
Mailing Address - Phone:970-221-9451
Mailing Address - Fax:855-856-6479
Practice Address - Street 1:3810 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538
Practice Address - Country:US
Practice Address - Phone:970-221-9451
Practice Address - Fax:855-856-6479
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE246852081P2900X
CO52746208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081304012Medicaid
NEP00656355OtherRAILROAD MEDICARE
NE01666OtherBCBS
IA1407902018Medicaid
NE01666OtherBCBS