Fetterman, Douglas M
Fetterman, Douglas M is an individual health care provider with primary practice located at 301 Prospect Ave , Syracuse NY 13203. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Critical Care Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Fetterman, Douglas M can be contacted via phone (315) 448-5440.Contact Information
Primary practice address
301 Prospect Ave
Syracuse NY 13203
Phone: (315) 448-5440
Fax: (315) 472-5010
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | L-251931-1 | New York |
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | L 1229891 | Michigan |
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207LC0200X | 251931 | New York |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 4301085208 | Michigan |
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 251931-1 | New York |
Profile Details
NPI number | 1043339971 |
---|---|
LBN Legal business name | Fetterman, Douglas M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 29th, 2007 |
Last updated | May 3rd, 2024 - about 7 months 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 | 1043339971 | NPPES |
New York | MEDICAID | 03124325 |
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