Provider Demographics
NPI:1154900298
Name:FEDER, JOSHUA ADAM
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ADAM
Last Name:FEDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 PLACE STEWART
Mailing Address - Street 2:
Mailing Address - City:MONTREAL
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H4M 2X2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 SMYTH ROAD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:ONTARIO
Practice Address - Zip Code:K1H 8L1
Practice Address - Country:CA
Practice Address - Phone:613-737-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ115025208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics