Provider Demographics
NPI:1891717377
Name:FELDMAN, GARY E (DPM)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:E
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710A ROCKLEDGE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2843
Mailing Address - Country:US
Mailing Address - Phone:301-515-0900
Mailing Address - Fax:240-912-2381
Practice Address - Street 1:6710A ROCKLEDGE DR STE 130
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2843
Practice Address - Country:US
Practice Address - Phone:301-515-0900
Practice Address - Fax:240-912-2381
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01247213EP1101X
VA0103300848213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0001OtherBLUESHIELD
MD252910600Medicaid
MD2130778OtherAETNA HMO
MD546270OtherBLUESHIELD
MD5544557OtherAETNA
MD352013OtherALLIANCE,MAMSI,MDIPA,OC
MD5544557OtherAETNA
MD252910600Medicaid
MD546270OtherBLUESHIELD
MD352013OtherALLIANCE,MAMSI,MDIPA,OC