Basic Information
| Provider Information | |||||||||
| NPI: | 1518910777 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEUER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 COMMUNICATIONS WAY | ||||||||
| Address2: | MACC-REVENUE CYCLE | ||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026011866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089578664 | ||||||||
| FaxNumber: | 5089578677 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 QUINLAN WAY | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087788835 | ||||||||
| FaxNumber: | 5087908989 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 05/18/2010 | ||||||||
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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 | 207RG0100X | 230109 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 26687-MD022810E | 01 | PA | HEALTH PARTNERS | OTHER | 0316813 | 01 | PA | CIGNA HMO/PPO | OTHER | 4208105 | 01 | PA | AETNA PPO | OTHER | 10447250 | 01 | PA | CAQH ID# | OTHER | 0566518 | 01 | PA | AETNA HMO | OTHER | 1011765300001 | 05 | PA | MEDICAID | 732729 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 30027049 | 01 | PA | KEYSTONE MERCY | OTHER | 0622328000 | 01 | PA | IBC - PC/KHPE | OTHER | 0622328000 | 01 | PA | AMERIHEALTH/INTERCOUNTY | OTHER |