Organization
MARC F. FEDDER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC FREDRIC FEDDER MD, FACP (PRESIDENT)
(336) 249-4296
Entity
Organization
Contact information
Practice address
206 W CENTER ST STE B, LEXINGTON, NC 27292-3056
(336) 249-4296
(336) 249-1893
Mailing address
PO BOX 557, LEXINGTON, NC 27293-0557
(336) 249-4296
(336) 249-1893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26817
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110006374
RAILROAD MEDICARE
—
01
—
2310
PARTNERS
—
01
—
31450
BLUE CROSS
—
05
—
8931450
—
NC
Enumeration date
02/27/2008
Last updated
12/14/2009
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