Provider Demographics
NPI:1942203344
Name:FEASTER, MARSHALL M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:M
Last Name:FEASTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 14623
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-4623
Mailing Address - Country:US
Mailing Address - Phone:610-988-8446
Mailing Address - Fax:610-988-4242
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:STE 1120
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1493
Practice Address - Country:US
Practice Address - Phone:610-374-5000
Practice Address - Fax:610-988-4242
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027165E208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29331Medicare UPIN
PA816736Medicare ID - Type Unspecified