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Individual
CAROL S FEDERIUK
Active
Individual
CAROL S FEDERIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
16560
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
16560
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD16560
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287970
—
OR
Enumeration date
05/09/2006
Last updated
02/04/2017
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