Provider Demographics
NPI:1639122070
Name:FELDMANN, JOHN EMERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EMERSON
Last Name:FELDMANN
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 1:2500 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4522
Mailing Address - Country:US
Mailing Address - Phone:336-621-2500
Mailing Address - Fax:336-478-2541
Practice Address - Street 1:2500 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4522
Practice Address - Country:US
Practice Address - Phone:336-621-2500
Practice Address - Fax:336-478-2541
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300596207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC7125OtherMEDCOST
NC803438OtherPARTNERS MEDICARE
NC89134NHMedicaid
NC4006538OtherAETNA
NC134NHOtherBCBS NC
C78846Medicare UPIN
NC2018674Medicare ID - Type UnspecifiedMEDICARE