Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | D18320 | MD |
NPI | 1013947126 |
---|---|
Provider Name | John H Fetting |
First Address | Baltimore, MD 21264-4474 |
Second Address | Lutherville, MD 21093-4535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 06/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
318741100 | (05) | MD |
C49199 | (02) | MD |