Individual
MICHAEL FEDAK
Active
Individual
MICHAEL FEDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36371
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010015
ESSENCE
MO
01
—
0400399
UHC
MO
01
—
100609
HEALTHLINK
MO
01
—
127478
GHP
MO
01
—
25552
BCBS
MO
01
—
A29062
MERCY
MO
Enumeration date
11/04/2005
Last updated
01/06/2025
Update your record
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