Individual
DR. COREY MICHAEL FIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 510-6200
(540) 857-5306
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0103301175
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103301175
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942566252
OPTIMA HEALTH PLAN
VA
05
—
1942566252
—
VA
01
—
540506332108
TRICARE
VA
Enumeration date
04/11/2012
Last updated
09/05/2025
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