Provider Demographics
NPI:1740405141
Name:DRS FELDMAN, PERL & MEZ
Entity Type:Organization
Organization Name:DRS FELDMAN, PERL & MEZ
Other - Org Name:CENTRAL MARYLAND PHOTOTHERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-552-5483
Mailing Address - Street 1:1645 LIBERTY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6521
Mailing Address - Country:US
Mailing Address - Phone:410-552-6483
Mailing Address - Fax:410-795-5078
Practice Address - Street 1:1645 LIBERTY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6521
Practice Address - Country:US
Practice Address - Phone:410-552-6483
Practice Address - Fax:410-795-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty