Fetterman, Bruce L
Fetterman, Bruce L is an individual health care provider with primary practice located at 7600 Wolf River Blvd Suite 220, Germantown TN 38138-1785. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otology & Neurotology, which is considered as his primary health care specialty. Fetterman, Bruce L can be contacted via phone (901) 755-5300.Contact Information
Primary practice address
7600 Wolf River Blvd Suite 220
Germantown TN 38138-1785
Phone: (901) 755-5300
Fax: (901) 756-0196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | MD29959 | Tennessee |
Profile Details
| NPI number | 1699881052 |
|---|---|
| LBN Legal business name | Fetterman, Bruce L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Dec 17th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699881052 | NPPES |
| Tennessee | Other | 4108473 | BC |
| Tennessee | MEDICAID | 3818743 | BC |
| Tennessee | Other | 97772 | BC |
| Tennessee | Other | P00238841 | BC |
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