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 | 
|---|
| Gender | Male | 
|---|
| Speciality | Dentist - General Practice | 
|---|
| Location | 100 N Mccoy St, Granville, Illinois | 
|---|
| 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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