Individual
TIMOTHY TAYLOR HOBBES FETTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-3076
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 797-6220
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
23934
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN3707
—
SC
Enumeration date
04/07/2020
Last updated
01/07/2022
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