Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 31811 | NC |
N | 207ND0900X | Dermatopathologist | 31811 | NC |
N | 207NS0135X | Procedural Dermatology | 31811 | NC |
NPI | 1720063175 |
---|---|
Provider Name | Steven Richard Feldman |
First Address | Charlotte, NC 28260-2658 |
Second Address | Winston Salem, NC 27104-3520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 28/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2002110000 | (05) | WV |
31516 | BCBS (01) | |
4514 | PARTNERS (01) | |
5869085 | AETNA (01) | |
5940168 | (05) | VA |
63997 | MEDCOST (01) | |
8931516 | (05) | NC |
C83730 | (02) | |
Q31811 | (05) | SC |