Individual
DR. CHARLES ROBERT FEDELE JR.
Active
Individual
DR. CHARLES ROBERT FEDELE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
C2-0010648
DE
2085R0202X
Diagnostic Radiology Physician
Primary
OS015710
PA
2085R0204X
Vascular & Interventional Radiology Physician
OS015710
PA
390200000X
Student in an Organized Health Care Education/Training Program
C7-0005091
DE
390200000X
Student in an Organized Health Care Education/Training Program
OT013503
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026726210001
—
PA
Enumeration date
05/17/2010
Last updated
05/06/2019
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