Provider Demographics
NPI:1801589338
Name:FELD, MAXWELL AARON (DC)
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:AARON
Last Name:FELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 ROSALYN CT APT 201
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2870
Mailing Address - Country:US
Mailing Address - Phone:651-815-7372
Mailing Address - Fax:
Practice Address - Street 1:1081 HIGHWAY 36 E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1988
Practice Address - Country:US
Practice Address - Phone:651-815-7372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor