Individual
ANGELA FEDORCUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
970 HOPE STREET, SUITE 6, BRISTOL, RI 02809-5210
(401) 254-0922
(401) 254-8894
Mailing address
970 HOPE STREET, SUITE 6, BRISTOL, RI 02809-5210
(401) 254-0922
(401) 254-8894
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1941
MA
213E00000X
Podiatrist
Primary
DPM260
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2700166
UNITED HEALTHCARE
—
01
—
70599
BLUE CROSS BLUE SHIELD
RI
05
—
9007059
—
RI
Enumeration date
10/04/2006
Last updated
07/08/2007
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