Provider Demographics
NPI:1215093588
Name:FELTMAN, MATTHEW KARL (RPH)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:KARL
Last Name:FELTMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8549 WOODS PT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-8112
Mailing Address - Country:US
Mailing Address - Phone:513-469-0182
Mailing Address - Fax:
Practice Address - Street 1:1014 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1141
Practice Address - Country:US
Practice Address - Phone:513-762-1095
Practice Address - Fax:513-762-1547
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-19000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist