Individual
MICHAEL DAVID FELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-4332
(765) 448-7689
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01094014A
IN
208800000X
Urology Physician
125.073121
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104321221
ANTHEM PTAN
IN
05
—
300093807
—
IN
Enumeration date
04/04/2018
Last updated
10/17/2024
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