Provider Demographics
NPI:1548404544
Name:FELDNER, BRYAN M (DPM)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:M
Last Name:FELDNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COPELAND MILL RD
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8977
Mailing Address - Country:US
Mailing Address - Phone:740-607-6720
Mailing Address - Fax:614-891-5411
Practice Address - Street 1:575 COPELAND MILL RD
Practice Address - Street 2:2F
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8977
Practice Address - Country:US
Practice Address - Phone:614-891-2828
Practice Address - Fax:614-891-5411
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003513213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000617778OtherANTHEM
OH36003513OtherSTATE LISCENSE
OH000000619101OtherANTHEM
OH4778110001OtherADMINASTAR
OH3020251Medicaid
OH4778110001OtherADMINASTAR
OH3020251Medicaid