Provider Demographics
NPI:1508883521
Name:FELEDY, JULES JR (MD)
Entity Type:Individual
Prefix:
First Name:JULES
Middle Name:
Last Name:FELEDY
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 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 818
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-654-5666
Mailing Address - Fax:301-654-5552
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 818
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-654-5666
Practice Address - Fax:301-654-5552
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063097208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I19343Medicare UPIN
G02358Medicare PIN