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Individual
NICHOLAS PETER FEDOR
Active
Individual
NICHOLAS PETER FEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-14219
NC
363A00000X
Physician Assistant
0110009963
VA
363A00000X
Physician Assistant
10320
AZ
363A00000X
Physician Assistant
2427
TN
363A00000X
Physician Assistant
Primary
2427
—
363A00000X
Physician Assistant
PA.0008506
CO
363A00000X
Physician Assistant
PA18159
TX
Other
Enumeration date
10/24/2013
Last updated
08/12/2026
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