Provider Demographics
NPI:1558359364
Name:FELDBAUM, DAVID MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:FELDBAUM
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 1:2205 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3611
Mailing Address - Country:US
Mailing Address - Phone:954-964-6684
Mailing Address - Fax:954-964-6649
Practice Address - Street 1:2205 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3611
Practice Address - Country:US
Practice Address - Phone:954-964-6684
Practice Address - Fax:954-964-6649
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME793472086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL172300OtherJMH HEALTH PLAN
FL2012518OtherCIGNA
FL035548OtherNEIGHBORHOOD HEALTH PLAN
FL49531OtherBLUE CROSS/BLUE SHIELD
FL258140000Medicaid
FL267206OtherAVMED
FL3700063OtherUNITED HEALTH CARE
FL258140000Medicaid
FL49531OtherBLUE CROSS/BLUE SHIELD