Individual
DR. DONALD EDWARD FETTEROLF
Active
Individual
DR. DONALD EDWARD FETTEROLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD023825-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058175
GA STATE LICENSE NUMBER
GA
01
—
MD023825E
PA STATE LICENSE NUMBER
PA
Enumeration date
12/11/2006
Last updated
06/13/2016
Update your record
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