Provider Demographics
NPI:1356378194
Name:FETZER, ARTHUR E (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:E
Last Name:FETZER
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 1:5018 MEDICAL CENTER CIR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9661
Mailing Address - Country:US
Mailing Address - Phone:610-432-7760
Mailing Address - Fax:610-432-6562
Practice Address - Street 1:5018 MEDICAL CENTER CIR
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9661
Practice Address - Country:US
Practice Address - Phone:610-432-7760
Practice Address - Fax:610-432-6562
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014833E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000642200Medicaid
PA50075245OtherCAPITAL BLUE CROSS
PA126650Medicare PIN
B36568Medicare UPIN