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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043339971 NPPES
New York MEDICAID 03124325

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