Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 14206 | AZ |
NPI | 1033103106 |
---|---|
Provider Name | Dr. Daniel B Feller |
First Address | Phoenix, AZ 85054-3105 |
Second Address | Phoenix, AZ 85054-3105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 23/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253443 | (05) | AZ |
C99462 | (02) |