Provider Demographics
NPI:1801876685
Name:FELDMANN, BRUCE ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ANTHONY
Last Name:FELDMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:116 E 11TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4364
Mailing Address - Country:US
Mailing Address - Phone:712-264-3500
Mailing Address - Fax:712-264-3535
Practice Address - Street 1:116 E 11TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4364
Practice Address - Country:US
Practice Address - Phone:712-264-3500
Practice Address - Fax:712-264-3535
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2010-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA31896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7142117Medicaid
IAI5500Medicare ID - Type Unspecified
IAG52786Medicare UPIN