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General NPI Number Information
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NPI Number | 1841154879
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Entity Type | Individual
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Provider Name | THEODORE P FECHTMEYER
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Gender | Male
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 945 MEMORIAL DR
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City | CAMBRIDGE
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State | MA
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Zip | 02138-6123
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Country | US
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Telephone | 612-501-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 1098 SUNBURST LN
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City | MIDWAY
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State | UT
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Zip | 84049-6488
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Country | US
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Telephone | 612-501-2050
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E931973
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License Number State | MA
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