Provider Demographics
NPI:1285650994
Name:FETCHERO, ROBERT M (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:FETCHERO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:M
Other - Last Name:FETCHERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:6321 ROUTE 30 FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9703
Mailing Address - Country:US
Mailing Address - Phone:724-671-1750
Mailing Address - Fax:724-523-7726
Practice Address - Street 1:6321 ROUTE 30 FL 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9703
Practice Address - Country:US
Practice Address - Phone:724-671-1750
Practice Address - Fax:724-523-7726
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005116L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine