Provider Demographics
NPI:1881696052
Name:FELDKAMP, MATTHIAS M (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHIAS
Middle Name:M
Last Name:FELDKAMP
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:9325 UPLAND LN N STE 205
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4474
Mailing Address - Country:US
Mailing Address - Phone:763-542-8888
Mailing Address - Fax:763-542-8899
Practice Address - Street 1:9325 UPLAND LN N STE 205
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4474
Practice Address - Country:US
Practice Address - Phone:763-542-8888
Practice Address - Fax:763-542-8899
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2021-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN44453207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN694498100Medicaid
MNH49998Medicare UPIN