Basic Information
| Provider Information | |||||||||
| NPI: | 1154389575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELDMAN | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2901 BOSTON ST | ||||||||
| Address2: | 613 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212244800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107320505 | ||||||||
| FaxNumber: | 4432637373 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 HOPKINS PLZ | ||||||||
| Address2: | DEPT OB GYN | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212012900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4432637338 | ||||||||
| FaxNumber: | 4432637373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 11/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D24839 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 3204758 | 05 | MA | MEDICAID |