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Individual

DR. GERALD L. FELDMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PHD

Contact information

Practice address
3950 BEAUBIEN ST FL 3, CHILDREN'S HOSPITAL OF MICHIGAN, DETROIT, MI 48201-2120
(313) 832-9324
(313) 993-8685
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(313) 832-9324
(313) 993-8685

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
4301055642
MI
207SG0202X
Clinical Biochemical Genetics Physician
4301055642
MI
207SG0203X
Clinical Molecular Genetics Physician
4301055642
MI
208000000X
Pediatrics Physician
4301055642
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
263022610
MI
01
700H262280
BLUE CROSS-BLUE CROSS
01
GF055642
CHAMPUS-CHAMPUS
Enumeration date
06/01/2006
Last updated
05/20/2016
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