Individual provider Active NPI

Charles William Fedde, M.D.

  • Surgery Physician
  • Oakland, MD
National Provider Identifier
1649507146
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0022336 Issued in MD
Practice address
410 Sam Snead Cir
Oakland, MD 21550-5507
Phone
(301) 334-2050
Fax
(301) 334-1792
NPI assigned
Nov 4, 2009
Last updated
Nov 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0022336 MD Primary

Addresses

Primary practice location

410 Sam Snead Cir
Oakland, MD 21550-5507

Mailing address

410 Sam Snead Cir
Oakland, MD 21550-5507
Phone (301) 334-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0022336MDMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1649507146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAM SNEAD CIR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215505507",
            "telephone_number": "301-334-2050",
            "fax_number": "301-334-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAM SNEAD CIR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215505507",
            "telephone_number": "301-334-2050",
            "fax_number": "301-334-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDE",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0022336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.