Provider Demographics
NPI:1912181215
Name:FECHTER, JOEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:D
Last Name:FECHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 GEORGIA AVE
Mailing Address - Street 2:STE 105A
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5020
Mailing Address - Country:US
Mailing Address - Phone:301-681-7100
Mailing Address - Fax:301-681-1494
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:STE 105A
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-681-7100
Practice Address - Fax:301-681-1494
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD46443174400000X
CAG067028174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132983Medicare PIN
MDF56440Medicare UPIN