Fetterolf, Michael Lynn

Fetterolf, Michael Lynn is an individual health care provider with primary practice located at 1405 Mill St , New London WI 54961-2155. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Fetterolf, Michael Lynn can be contacted via phone (920) 531-2400.

Contact Information

Primary practice address
1405 Mill St New London WI 54961-2155
Phone: (920) 531-2400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD031976E Pennsylvania
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X MD031976E Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 55231-20 Wisconsin

Profile Details

NPI number 1821069691
LBN Legal business name Fetterolf, Michael Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Dec 11th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821069691 NPPES
Pennsylvania MEDICAID 0010419750001
Pennsylvania Other 450030702
Pennsylvania Other 160011217

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