Individual
MRS. JULIA LYNN FETAHAGIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
Mailing address
1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
(317) 837-5566
(317) 837-5567
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000301
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170016855
RAILROAD MEDICARE PIN
IN
Enumeration date
08/20/2006
Last updated
03/31/2021
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