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Individual

CHRIS WILLIAM FELLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
549 FAIR ST, BLOOMSBURG, PA 17815-1419
(570) 387-2251
(570) 387-2206
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD039209E
PA
208D00000X
General Practice Physician
MD039209E
PA
208M00000X
Hospitalist Physician
Primary
MD039209E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110238261
RAILROAD MEDICARE
PA
05
11629520002
PA
01
118438711
DEPARTMENT OF LABOR
PA
01
214604G
GEISINGER
PA
01
232809429
TRICARE
PA
01
325055
HEALTH AMERICA
PA
01
414586
KEYSTONE
PA
01
50000875
CAPITAL BLUE CROSS
PA
Enumeration date
07/25/2006
Last updated
02/11/2021
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