Provider Demographics
NPI:1699942219
Name:FELDMAN, MATTHEW PHILLIP (MD MS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PHILLIP
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W SEVENTH ST
Mailing Address - Street 2:FREDERICK MEMORIAL HOSPITAL
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4506
Mailing Address - Country:US
Mailing Address - Phone:240-566-4722
Mailing Address - Fax:
Practice Address - Street 1:400 W SEVENTH ST
Practice Address - Street 2:FREDERICK MEMORIAL HOSPITAL
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4506
Practice Address - Country:US
Practice Address - Phone:240-566-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD72399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program