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Individual

DR. ARNOLD C. FELLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1701 BALDWIN AVE, SUITE 207, PONTIAC, MI 48340-3412
(248) 858-2255
(248) 858-8010
Mailing address
1701 BALDWIN AVE, SUITE 207, PONTIAC, MI 48340-3412
(248) 858-2255
(248) 858-8010

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301029683
MI
207ND0900X
Dermatopathology Physician
4301029683
MI
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
4301029683
MI
207NP0225X
Pediatric Dermatology Physician
4301029683
MI
207NS0135X
Procedural Dermatology Physician
4301029683
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01361A
HAP
MI
01
0706316251
BLUE CROSS BLUE SHIELD
MI
01
4033181
AETNA
MI
01
71045012
MEDICARE TRAVELERS
MI
01
MO13980
CHAMPUS
MI
Enumeration date
10/06/2005
Last updated
02/28/2008
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