Individual provider · NPI-1

Dmitry P. Feldman, DO

Internal Medicine · Mount Vernon, WA

NPI number1629247689
StatusActive
Last updated in NPPESNov 9, 2010

Details

NPI
1629247689
Entity type
Individual (NPI-1)
Name
Dmitry P. Feldman
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Feb 25, 2008
Last updated
Nov 9, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineOP60097298WAYes
207R00000X Internal MedicineSL0454NV
208M00000X HospitalistOP60097298WA

Practice location

1415 E. Kincaid Street
Mount Vernon, WA 98274

Phone 360-416-5750 · Fax 360-416-5758

Mailing address

1400 E. Kincaid Street
Mount Vernon, WA 98274-4127

Phone 360-428-2500 · Fax 360-428-6485

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