Individual
DR. ALLAN L. FEDOSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4554 E HIGHWAY 20, NICEVILLE, FL 32578-9755
(850) 897-1824
(850) 897-1827
Mailing address
PO BOX 5008, NICEVILLE, FL 32578-5008
(850) 897-1824
(850) 897-1827
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0029230
GU
Other
Enumeration date
07/31/2006
Last updated
05/01/2012
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