Provider Demographics
NPI:1891777405
Name:FEHR, MARTHA A (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:FEHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-368-3150
Mailing Address - Fax:508-368-3152
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 230S
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3150
Practice Address - Fax:508-368-3152
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA780022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
AA3710OtherHARVARD PILGRIM
J14259OtherBLUE SHIELD INDEMNITY
J14259OtherBLUE SHIELD HMO BLUE
0500191OtherEVERCARE
1044150OtherCIGNA
464655OtherTUFTS HEALTH PLAN
042472266OtherTRICARE / CHAMPUS
26808OtherHEALTHY START
042472266OtherTHREE RIVERS
130018948OtherRAILROAD MEDICARE
4465395OtherAETNA
935011OtherFIRST HEALTH
MA3115224Medicaid
784018OtherMVP HEALTH CARE
J14259OtherBLUE CARE ELECT
042472266OtherUNITED HEALTHCARE
991067OtherFALLON COMMUNITY HEALTH
E71242Medicare UPIN
J14259OtherBLUE SHIELD HMO BLUE