Provider Demographics
NPI:1740272921
Name:FELDMAN, MARTIN ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ALAN
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3620 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2020
Mailing Address - Country:US
Mailing Address - Phone:602-230-7373
Mailing Address - Fax:602-230-5105
Practice Address - Street 1:750 E THUNDERBIRD RD STE 1-3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5306
Practice Address - Country:US
Practice Address - Phone:602-230-7373
Practice Address - Fax:602-218-6383
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2021-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860676047OtherTAX ID
AZ1072107OtherCIGNA
AZ4240133OtherAETNA
AZAZ0062880OtherBCBS OF AZ
AZ22072104OtherICA
AZ0179654OtherDEPT OF LABOR & INDUSTRIE
AZ1Z8791OtherHEALTHNET
AZ265711Medicaid
AZE85984Medicare UPIN
AZZ160510Medicare PIN