Provider Demographics
NPI:1881679165
Name:FELDMAN, STEVEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5821 W MAPLE RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2275
Mailing Address - Country:US
Mailing Address - Phone:248-855-0407
Mailing Address - Fax:248-855-1323
Practice Address - Street 1:5821 W MAPLE RD
Practice Address - Street 2:SUITE 190
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2275
Practice Address - Country:US
Practice Address - Phone:248-855-0407
Practice Address - Fax:248-855-1323
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2011-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301043842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1881679165Medicaid
MI110F375900OtherBLUE SHIELD
MI06307091OtherBCBS INDIVIDUAL
MI110202020OtherRR MEDICARE
MIB46648Medicare UPIN
MI1881679165Medicaid