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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