Individual
CHERYL BAKER FEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1001 E BRIDGE ST STE A, BRIGHTON, CO 80601-2276
(303) 659-3036
(303) 659-0053
Mailing address
1001 E BRIDGE ST, SUITE A, BRIGHTON, CO 80601-2275
(303) 659-3036
(303) 359-0053
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2051528
MI
152W00000X
Optometrist
Primary
2839
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12263171
CAQH PROVIDER ID
—
05
—
85324001
—
CO
Enumeration date
07/20/2011
Last updated
08/10/2020
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