Individual
PAUL A FEDALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
540 S GOVERNORS AVE STE 101A, DOVER, DE 19904-3530
(302) 744-7980
(302) 744-7989
Mailing address
640 S. STATE STREET, MAIL CODE 3055, DOVER, DE 19901
(302) 480-1688
(302) 480-9807
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
C1-0007342
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000032899
—
DE
Enumeration date
08/16/2005
Last updated
10/01/2021
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