Provider Demographics
NPI:1881668556
Name:FITTERLING, JAMES MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:FITTERLING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALASKA VA HEALTHCARE SYSTEM AND REGIONAL OFFICE
Mailing Address - Street 2:3001 C STREET
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3913
Mailing Address - Country:US
Mailing Address - Phone:907-273-4078
Mailing Address - Fax:
Practice Address - Street 1:3001 C ST
Practice Address - Street 2:ALASKA VA HEALTHCARE SYSTEM AND REGIONAL OFFICE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3913
Practice Address - Country:US
Practice Address - Phone:907-273-4078
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS28-384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical