Individual
MICHAEL J FEDEWA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4389 BEAUFORT RD, NAVAL HEALTH CLINIC, CHERRY POINT, NC 28533-2100
(910) 450-4159
(910) 450-4194
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2013-01911
NC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/08/2012
Last updated
12/08/2017
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