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Individual
MATHIAS H FETTIG
Active
Individual
MATHIAS H FETTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01017556
UNITED HEALTHCARE
MT
05
—
0390762
—
MT
01
—
80
STATE LICENSE
MT
01
—
94500
BCBS
MT
01
—
P00062610
RAILROAD MEDICARE
MT
Enumeration date
02/01/2006
Last updated
05/25/2010
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