Provider Demographics
NPI:1992598742
Name:FEASTER, KARL
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:FEASTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 BANDY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8026
Mailing Address - Country:US
Mailing Address - Phone:704-574-7080
Mailing Address - Fax:
Practice Address - Street 1:6207 BANDY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-8026
Practice Address - Country:US
Practice Address - Phone:704-574-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program