Individual
THEODORE FEDEROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 728-5908
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 728-5908
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS009510L
PA
Other
Enumeration date
07/03/2006
Last updated
07/09/2007
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