Provider Demographics
NPI:1114715315
Name:FESLER, BRIAN SCOTT
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:SCOTT
Last Name:FESLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 MCLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-2204
Mailing Address - Country:US
Mailing Address - Phone:734-225-3413
Mailing Address - Fax:
Practice Address - Street 1:1816 MCLAIN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2204
Practice Address - Country:US
Practice Address - Phone:734-225-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health