Individual
PAUL J FETTERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FACOG
Contact information
Practice address
1001 7TH ST NE, DEVILS LAKE, ND 58301-2719
(701) 662-2157
(701) 662-4116
Mailing address
PO BOX 1100, DEVILS LAKE, ND 58301-1100
(701) 662-2157
(701) 662-4116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7419
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18821
—
ND
Enumeration date
07/14/2005
Last updated
03/21/2014
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