Individual
MATTHEW C FEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 HAWTHORNE AVE SE STE 110, SALEM, OR 97301
(503) 814-4440
(503) 814-4444
Mailing address
PO BOX 886, SALEM, OR 97308-0886
(503) 814-4440
(503) 814-4444
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD27542
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274652
—
OR
01
—
R152647
MEDICARE
OR
Enumeration date
10/05/2006
Last updated
07/11/2018
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