Individual
RICHARD ALAN FEDERSPIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-2424
(765) 463-2249
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01026230
IN
207N00000X
Dermatology Physician
Primary
01026230A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085566
BLUE CROSS BLUE SHIELD
IN
01
—
070015351
MEDICARE RAILROAD
IN
Enumeration date
11/14/2006
Last updated
07/05/2023
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