Individual
DR. AVA RISA FELDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
12327 STRATFORD DR, CLIVE, IA 50325-8148
(515) 224-7088
(515) 224-9228
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9034
(920) 663-0370
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
02136
IA
207ND0101X
MOHS-Micrographic Surgery Physician
02136
IA
207ND0900X
Dermatopathology Physician
Primary
02136
IA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
02136
IA
207NP0225X
Pediatric Dermatology Physician
02136
IA
207NS0135X
Procedural Dermatology Physician
02136
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070007615
MEDICARE RAILROAD
IA
05
—
2298364
—
IA
Enumeration date
07/05/2005
Last updated
07/21/2022
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