Provider Demographics
NPI:1740488485
Name:FELDER, DEVRON JOHN
Entity type:Individual
Prefix:MR
First Name:DEVRON
Middle Name:JOHN
Last Name:FELDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 E HAGGARD AVE
Mailing Address - Street 2:
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244-8417
Mailing Address - Country:US
Mailing Address - Phone:336-278-2000
Mailing Address - Fax:
Practice Address - Street 1:762 E HAGGARD AVE
Practice Address - Street 2:
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244-8417
Practice Address - Country:US
Practice Address - Phone:336-278-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman