Individual
DR. JORDAN DANIEL FETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-4500
(336) 713-4501
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301110615
MI
2080P0214X
Pediatric Pulmonology Physician
Primary
2022-02032
NC
Other
Enumeration date
06/21/2016
Last updated
03/02/2023
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