Provider Demographics
NPI:1285764761
Name:FELD, JEFFREY A (DPM)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:FELD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936A GENERAL BOOTH BLVD
Mailing Address - Street 2:PODIATRY ASSOCIATES OF VIRGINIA
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-4857
Mailing Address - Country:US
Mailing Address - Phone:757-228-1955
Mailing Address - Fax:
Practice Address - Street 1:936A GENERAL BOOTH BLVD
Practice Address - Street 2:PODIATRY ASSOCIATES OF VIRGINIA
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-4857
Practice Address - Country:US
Practice Address - Phone:757-228-1955
Practice Address - Fax:757-228-3095
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300851213E00000X
SC553213E00000X
NYNO05808213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA480000738Medicare ID - Type Unspecified