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Michael Lynn Fetterolf, MD
Family Medicine Physician in New London, Wisconsin
NPI 1821069691

Michael Lynn Fetterolf is a Family Medicine Physician based in Appleton, WI. Michael Lynn Fetterolf practices in New London, WI and has the professional credentials of MD. The NPI Number for Michael Lynn Fetterolf is 1821069691 and holds a License No. MD031976E (Wisconsin).

The current practice location address for Michael Lynn Fetterolf is 1405 Mill St, New London, WI and can be reached out via phone at 920-531-2400.

Location: 1405 Mill St, New London, WI, 54912-8003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821069691
Provider Name
Michael Lynn Fetterolf
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1405 Mill St, New London, WI, 54912-8003
Phone Number
920-531-2400
Fax Number
Provider Enumeration Date
01/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0010419750001 05 PA
450030702 01 WI MEDICARE PTAN
160011217 01 PA RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
1405 Mill St
City
New London
State
Wisconsin
Zip
54961-2155
Phone Number
920-531-2400
Fax Number
person
Provider Business Mailing Address Details
Address
1405 Mill St
City
New London
State
Wisconsin
Zip
54961-2155
Phone Number
920-531-2400
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
MD031976E (Pennsylvania)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Obstetrics
Taxonomy
207VX0000X
License No.
MD031976E (Pennsylvania)
Definition
Definition to come...
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