Dr Evan Deuth Fiedler, DDS is a
Dentist - General Practice based in Granville, Illinois. Dr Evan Deuth Fiedler is licensed to practice in Illinois (license number 019027937) and his current practice location is
100 N Mccoy St, Granville, Illinois. He can be reached at his office (for appointments etc.) via phone at
(815) 339-6888.
NPI number for Dr Evan Deuth Fiedler is 1104054022 and his current mailing address is 100 N Mccoy St, P.o. Box 597, Granville, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104054022.
Healthcare Provider's Profile
Full Name | Dr Evan Deuth Fiedler |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 100 N Mccoy St, Granville, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1104054022
- Provider Enumeration Date: 06/30/2009
- Last Update Date: 03/25/2010
Medical Identifiers
Medical identifiers for Dr Evan Deuth Fiedler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104054022 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 019027937 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Evan Deuth Fiedler is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Evan Deuth Fiedler, DDS 100 N Mccoy St, P.o. Box 597, Granville, IL 61326-9329 Ph: (815) 339-6888 | Dr Evan Deuth Fiedler, DDS 100 N Mccoy St, Granville, IL 61326-9329 Ph: (815) 339-6888 |
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