Individual
C. NICHOLAS FETKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
395 W 12TH AVE FL 4, COLUMBUS, OH 43210-1267
(614) 293-8315
Mailing address
395 W 12TH AVE FL 4, COLUMBUS, OH 43210-1267
(614) 293-8315
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35094258
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004797
—
OH
Enumeration date
05/14/2008
Last updated
10/17/2017
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