Provider Demographics
NPI:1689894867
Name:FELDMAN, DUSTIN BLAKE (DO)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:BLAKE
Last Name:FELDMAN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:29992 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:32255 NORTHWESTERN HWY STE 50
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1572
Practice Address - Country:US
Practice Address - Phone:947-227-8420
Practice Address - Fax:947-227-8421
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2023-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI5101016881207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine