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Individual

DR. STEPHEN G FEDEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
400 COLONNADE DR STE 230, PONTE VEDRA, FL 32081-6237
(904) 271-7540
(904) 376-3204
Mailing address
PO BOX 746652, ATLANTA, GA 30374-6652
(904) 202-2092
(904) 376-4075

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25MB0593880
NJ
207RC0000X
Cardiovascular Disease Physician
30762
GA
207RC0000X
Cardiovascular Disease Physician
83246
SC
207RC0000X
Cardiovascular Disease Physician
Primary
OS9424
FL
207RI0011X
Interventional Cardiology Physician
OS9424
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
832460
SC
Enumeration date
01/23/2006
Last updated
12/02/2025
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