Basic Information
| Provider Information | |||||||||
| NPI: | 1982686630 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELER | ||||||||
| FirstName: | CLAUDIO | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 20970 | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820037020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076329261 | ||||||||
| FaxNumber: | 3076349170 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 HOUSE AVE | ||||||||
| Address2: | SUITE 505 | ||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820013176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076329261 | ||||||||
| FaxNumber: | 6076349170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2005 | ||||||||
| LastUpdateDate: | 11/17/2016 | ||||||||
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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 | 207T00000X | MD17514 | TN | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 50312 | CO | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 9812A | WY | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 3051264 | 05 | TN | MEDICAID | 25900544 | 05 | CO | MEDICAID |