Individual
STEVEN D FETZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3301 BROADWAY ST, QUINCY, IL 62301-3713
(217) 222-6550
Mailing address
3301 BROADWAY ST, QUINCY, IL 62301-3713
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2011040013
MO
367500000X
Certified Registered Nurse Anesthetist
209000132
IL
Other
Enumeration date
01/18/2007
Last updated
01/24/2021
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