Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 05-33759 | KS |
Y | 2080P0205X | Pediatric Endocrinologist | 2009011804 | MO |
NPI | 1073727269 |
---|---|
Provider Name | Dr. Matthew Maximilian Feldt |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64111-2659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 15/10/2015 |