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Individual
TIMOTHY FETTERMAN
Active
Individual
TIMOTHY FETTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-071569
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198967
ANTHEM
OH
01
—
0005168421
AETNA
OH
01
—
0105480
UNITED HEALTH CARE
OH
01
—
080176792
RAILROAD MEDICARE PIN
OH
01
—
0843940002
DMERC
OH
05
—
2001470
—
OH
05
—
2238199
—
OH
01
—
84779
QUAL CHOICE
OH
01
—
CG4860
RAILROAD MEDICARE GROUP
OH
01
—
P00478745
RAILROAD CARE
OH
01
—
P00701420
RAILROAD CARE
OH
Enumeration date
12/29/2005
Last updated
06/03/2022
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