Provider Demographics
NPI:1598727992
Name:FELDMAN, CARY S
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:S
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 OAKWOOD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1360
Mailing Address - Country:US
Mailing Address - Phone:734-459-7444
Mailing Address - Fax:734-459-7755
Practice Address - Street 1:811 OAKWOOD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1360
Practice Address - Country:US
Practice Address - Phone:734-459-7444
Practice Address - Fax:734-459-7755
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICF044972208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA74783Medicare UPIN
MI0632004Medicare ID - Type Unspecified