National Provider Identifier

Craig M Fetterman, DO

Craig M Fetterman, DO is listed in the NPPES registry with a primary specialty of Hospitalist Physician in Kenmore, NY and a listed phone number of (716) 634-8800.

NPI 1902868383Kenmore, NYHospitalist Physician

Profile Overview

NPI
1902868383
Provider Type
Individual
Primary Specialty
Hospitalist Physician
Enumeration Date
April 03, 2006
Last Updated
August 26, 2022

Practice Location

  • 2950 Elmwood Ave
  • Kenmore, NY 14217-1304

Phone: (716) 634-8800

Mailing Address

  • 40 Main St
  • Hamburg, NY 14075-4948

Specialties

  • Hospitalist Physician (208M00000X)
  • Internal Medicine Physician (207R00000X)
Full Record
NPI
1902868383
Entity Type
Individual
Last Name
Fetterman
First Name
Craig
Middle Name
M
Credential
DO
Mailing Street Address
40 Main St
Mailing City
Hamburg
Mailing State
NY
Mailing ZIP Code
14075-4948
Mailing Country
US
Mailing Phone
(716) 649-0887
Mailing Fax
(716) 646-4611
Practice Street Address
2950 Elmwood Ave
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-1304
Practice Country
US
Practice Phone
(716) 634-8800
Practice Fax
(716) 634-8987
Enumeration Date
April 03, 2006
Last Updated
August 26, 2022
Sex
Male
Sole Proprietor
Yes
Certification Date
August 26, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Hospitalist Physician (208M00000X), Internal Medicine Physician (207R00000X)
Other Identifiers
0412489 (NY, Independent Health), 000527760001 (NY, Bc/Bs), 0026827302 (NY, Univera), 02533062 (NY), 041006000116 (NY, Fidelis)