Provider Demographics
NPI:1831278779
Name:FELDMAN, ROBERT STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-0013
Mailing Address - Country:US
Mailing Address - Phone:706-635-5111
Mailing Address - Fax:706-636-5438
Practice Address - Street 1:822 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-3804
Practice Address - Country:US
Practice Address - Phone:706-635-5111
Practice Address - Fax:706-636-5438
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0289772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00333891AMedicaid