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Organization
CRAIG M. FETTERMAN, D.O.,P.C.
Active
Organization
CRAIG M. FETTERMAN, D.O.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG M FETTERMAN D.O. (PRESIDENT)
(716) 634-8800
Entity
Organization
Contact information
Practice address
2950 ELMWOOD AVE, KENMORE, NY 14217-1304
(716) 634-8800
(716) 634-8987
Mailing address
200 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-8217
(716) 634-8800
(716) 634-8987
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
230757-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026827302
UNIVERA
NY
05
—
02533062
—
NY
01
—
0412489
INDEPENDENT HEALTH
NY
01
—
061106000022
FIDELIS
NY
Enumeration date
02/21/2007
Last updated
09/19/2007
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