Individual provider · NPI-1

Dr. Matthew Feldhammer, PhD

Pathology, Clinical Laboratory Director, Non-physician · Jacksonville, FL

NPI number1477143733

StatusActive

Last updated in NPPESJan 21, 2021

Details

NPI: 1477143733
Entity type: Individual (NPI-1)
Name: Dr. Matthew Feldhammer
Credential: PhD
Sex: Male
Sole proprietor: No
Enumeration date: Jan 21, 2021
Certification date: Jan 21, 2021
Last updated: Jan 21, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
247ZC0005X	Pathology, Clinical Laboratory Director, Non-physician	DL49402	FL	Yes
246QC1000X	Spec/Tech, Pathology, Chemistry	1225	DE
246QI0000X	Spec/Tech, Pathology, Immunology	–	–
246QL0901X	Spec/Tech, Pathology, Laboratory Management, Diplomate	–	–
246ZB0500X	Specialist/Technologist, Other, Biochemist	–	–

Practice location

655 W 8th St
Jacksonville, FL 32209-6511

Phone 904-244-5076

Mailing address

655 W 8th St # C504
Jacksonville, FL 32209-6511

Phone 904-244-5076

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