Provider Demographics
NPI:1225016215
Name:FELDMAN, NATHAN IRWIN (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:IRWIN
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-5658
Mailing Address - Country:US
Mailing Address - Phone:610-933-5340
Mailing Address - Fax:610-917-1230
Practice Address - Street 1:500 LOGAN RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-5658
Practice Address - Country:US
Practice Address - Phone:610-933-5340
Practice Address - Fax:610-917-1230
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-031826-E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01-1050698Medicaid
PA01-1050698Medicaid
PAC33355Medicare UPIN