Provider Demographics
NPI:1215978838
Name:FELDMAN, LYNN F (DO)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:F
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:345 FRESHFIELDS DR
Practice Address - Street 2:STE J101
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-5443
Practice Address - Country:US
Practice Address - Phone:843-768-4800
Practice Address - Fax:843-768-1124
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC007520Medicaid
SCP00406078OtherRAILROAD MEDICARE #
SCP00886829OtherRAILROAD MC ID-RSFPN
SCP00886829OtherRAILROAD MC ID-RSFPN
SCP00406078OtherRAILROAD MEDICARE #
SCE167319223Medicare PIN