Provider Demographics
NPI:1760640593
Name:DANIEL DONAVAN FEENEY MD
Entity Type:Organization
Organization Name:DANIEL DONAVAN FEENEY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DONAVAN
Authorized Official - Last Name:FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-898-2229
Mailing Address - Street 1:1250 N POST RD STE B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4232
Mailing Address - Country:US
Mailing Address - Phone:317-898-2229
Mailing Address - Fax:317-898-0838
Practice Address - Street 1:1250 N POST RD STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4232
Practice Address - Country:US
Practice Address - Phone:317-898-2229
Practice Address - Fax:317-898-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100217020Medicaid
IN207170Medicare PIN
INF54034Medicare UPIN