Organization
ARNOLD C. FELLMAN, M.D., P.C.
Active
Organization
ARNOLD C. FELLMAN, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARNOLD C. FELLMAN M.D. (PRESIDENT)
(248) 858-2255
Entity
Organization
Contact information
Practice address
1701 BALDWIN AVE, SUITE 207, PONTIAC, MI 48340-3412
(248) 858-2255
(248) 858-8010
Mailing address
1701 BALDWIN AVE, SUITE 207, PONTIAC, MI 48340-3412
(248) 858-2255
(248) 858-8010
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301029683
MI
207ND0900X
Dermatopathology Physician
4301029683
MI
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
4301029683
MI
207NP0225X
Pediatric Dermatology Physician
4301029683
MI
207NS0135X
Procedural Dermatology Physician
4301029683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01361A
HAP
MI
01
—
070F339580
BLUE CROSS BLUE SHIELD
MI
01
—
0P46320
MEDICARE GROUP NUMBER
MI
05
—
101063382
—
MI
01
—
4033181
AETNA
MI
01
—
71045012
MEDICARE TRAVELERS
MI
01
—
MO13980
CHAMPUS
MI
Enumeration date
06/24/2007
Last updated
02/28/2008
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