Fedore, Daniel W.

Fedore, Daniel W. is an individual health care provider with primary practice located at 4140 Centennial Hills Blvd Ste A, Casper WY 82609. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fedore, Daniel W. can be contacted via phone (307) 265-7205.

Contact Information

Primary practice address
4140 Centennial Hills Blvd Ste A Casper WY 82609
Phone: (307) 265-7205
Fax: (307) 235-6262
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 247 Wyoming

Profile Details

NPI number 1902899230
LBN Legal business name Fedore, Daniel W.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Jun 11th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902899230 NPPES
Wyoming Other 312443 BCBS
Wyoming Other P00059533 BCBS
Wyoming MEDICAID 117270100 BCBS

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