Provider Demographics
NPI:1790096113
Name:FIEDLER, DAVID KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KENNETH
Last Name:FIEDLER
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 1:301 E. 17TH STREET
Mailing Address - Street 2:ROOM 1402 NYU HJD DEPT. OF ORTHOPAEDIC SURGERY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-598-6509
Mailing Address - Fax:212-598-7654
Practice Address - Street 1:4551 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2782
Practice Address - Country:US
Practice Address - Phone:850-464-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA68408207X00000X, 207XS0106X
FLME128529207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery