Provider Demographics
NPI:1689794513
Name:FEELY, MICHAEL GRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GRAY
Last Name:FEELY
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 1:110 N 175TH ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-3582
Mailing Address - Country:US
Mailing Address - Phone:402-596-4411
Mailing Address - Fax:
Practice Address - Street 1:110 N 175TH ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3582
Practice Address - Country:US
Practice Address - Phone:402-596-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23638207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine