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MARK FEDDER MD PC NPI 1184806101


NPI Information

NPI: 1184806101
Provider Name: MARK FEDDER, MD, PC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
6810 STATE ROUTE 162
SUITE 211
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-0346
Get Directions

MARK FEDDER, MD, PC is a gastroenterology internal medicine in Maryville, IL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. MARK FEDDER, MD, PC NPI is 1184806101. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6810 STATE ROUTE 162
SUITE 211
MARYVILLE, IL
ZIP 62062-501
Phone: (618) 288-0346
Fax: (618) 288-0349

The provider's authorized official is Mark Stephen Fedder .
The authorized official title is Owner/president and has the following contact phone number (618) 288-0346.

The enumeration date for this NPI number is 11/30/2007 and was last updated on 11/30/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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