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General NPI Number Information
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NPI Number | 1194712620
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Entity Type | Individual
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Provider Name | JOHN DAVID FETZER DPM
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 335 E WATERLOO RD
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City | AKRON
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State | OH
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Zip | 44319-1218
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Country | US
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Telephone | 330-724-8689
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Fax | 330-724-5470
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Provider Business Mailing Address
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Address Line | 335 E WATERLOO RD
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City | AKRON
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State | OH
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Zip | 44319-1218
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Country | US
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Telephone | 330-724-8689
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Fax | 330-724-5470
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 36.002423
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License Number State | OH
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