Provider Demographics
NPI:1467471193
Name:FELDMAN, DANIEL P (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:P
Last Name:FELDMAN
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 1:340 E 1ST AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020
Mailing Address - Country:US
Mailing Address - Phone:303-469-3182
Mailing Address - Fax:303-469-4693
Practice Address - Street 1:340 E 1ST AVE
Practice Address - Street 2:STE 102
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020
Practice Address - Country:US
Practice Address - Phone:303-469-3182
Practice Address - Fax:303-469-4693
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25376207L00000X
GA52436208VP0014X
GA052436207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00211626OtherRAILROAD MEDICARE
ORA063OtherTRICARE
OR277815Medicaid
ORA063OtherTRICARE
OR277815Medicaid