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General NPI Number Information
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NPI Number | 1013947126
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Entity Type | Individual
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Provider Name | JOHN H FETTING M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 10753 FALLS RD
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City | LUTHERVILLE
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State | MD
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Zip | 21093-4535
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Country | US
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Telephone | 410-583-2970
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64474
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City | BALTIMORE
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State | MD
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Zip | 21264-4474
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Country | US
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Telephone | 410-955-8964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | D18320
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License Number State | MD
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