MICHAEL D FETTERS (NPI# 1144318668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144318668 |
| Entity Type | Individual |
| Full Name | MICHAEL D FETTERS |
| Credential | MD |
| Practice Address |
24 Frank Lloyd Wright Dr Lobby H Ann Arbor MI 48105-9484 |
| Mailing Address |
3621 S State St 700 Kms Place Ann Arbor MI 48108 |
| Practice Telephone | 7346475640 |
| Mailing Telephone | 7349362047 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301063810 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3146395 | 05 |
| Street Address |
24 FRANK LLOYD WRIGHT DR LOBBY H |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48105-9484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174529127 | Paula Tuohy Miska | Nurse Practitioner | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48109 | 2005-06-23 |
| 1629540992 | Regents of The University of Michigan | Durable Medical Equipment & Medical Supplies | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-12-26 |
| 1477021160 | Lisa Jane Bosio | Registered Nurse | 24 Frank Lloyd Wright Dr, Lobby C Suite 1300, Ann Arbor, MI 48105-9484 | 2018-11-12 |
| 1770073199 | Regents of The University of Michigan | Dietitian, Registered | 24 Frank Lloyd Wright Dr, Dominos Farms Lobby C Suite 1300, Ann Arbor, MI 48106 | 2018-05-10 |
| 1861998411 | Dale Douglas Hazard | Physical Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-04-03 |
| 1144724303 | Kanisha Ward | Specialist/Technologist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-22 |
| 1851894109 | Kristy Jo Bonasso | Occupational Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-13 |
| 1932602612 | Eric Kilpatrick | Specialist/Technologist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-09 |
| 1679075659 | Kristen Hope Schuyten | Physical Therapist | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-06 |
| 1912409897 | Gary Kufel | Physical Medicine & Rehabilitation | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730728718 | Alexander Jendrusina | Psychologist | Va Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105 | 2019-12-23 |
| 1417515875 | Christine Shyh Wang | Student in an Organized Health Care Education/Training Program | 4029 Avenue Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2019-05-31 |
| 1013475003 | Ryan Wang | Physician Assistant | 4883 S. Ridgeside Cir, Ann Arbor, MI 48105 | 2019-03-08 |
| 1801366265 | Amruta Sonavaria | Physical Therapist | 4701 East Huron River Drive, Ann Arbor, MI 48105 | 2018-11-28 |
| 1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
| 1902398464 | Austin Remington | Student in an Organized Health Care Education/Training Program | 4029 Ave Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2018-05-31 |
| 1881191658 | Stephen James Hickner | Student in an Organized Health Care Education/Training Program | St. Mary Mercy Outpatient Psychiatric Services, 2006 Hogback Road, Suite 1, Ann Arbor, MI 48105 | 2018-04-09 |
| 1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
| 1861857971 | Connie Chen | Pharmacist | 2215 Fuller Road (119), Ann Arbor, MI 48105 | 2015-12-17 |
| 1407241193 | Stefan Craciun | Emergency Medicine | 3484 Ashburnam Rd, Ann Arbor, MI 48105 | 2015-03-31 |
| Find all providers in zip 48105 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164950481 | Ryan Kenneth Smith | Family Medicine | 4350 Jackson Rd Ste 230, Ann Arbor, MI 48103-1890 | 2017-05-31 |
| 1730620386 | Rachel Denny | Family Medicine | 4260 Plymouth Rd # B1-313, Ann Arbor, MI 48109-2700 | 2017-03-15 |
| 1730546722 | Scott Waclawik | Family Medicine | 24 Frank Lloyd Wright Dr Ste L2300, Ann Arbor, MI 48105-9484 | 2016-01-21 |
| 1477940294 | Advance Primary Care | Family Medicine | 1000 E Stadium Blvd Ste E, Ann Arbor, MI 48104-4616 | 2015-04-20 |
| 1598179822 | Kristina L Bahrou | Family Medicine | 3830 Packard St Ste 230, Ann Arbor, MI 48108-2273 | 2014-06-14 |
| 1164862249 | Gregory David Shumer | Family Medicine | 24 Frank Lloyd Wright Dr Lbby H, Ann Arbor, MI 48105-9484 | 2013-07-03 |
| 1629321096 | Rachel Leah Sabb | Family Medicine | 1000 Markbarry Dr, Ann Arbor, MI 48105-2869 | 2012-10-22 |
| 1336401124 | Sukhpreet Kaur Singh | Family Medicine | 2755 Carpenter Rd Ste 1s, Ann Arbor, MI 48108-1171 | 2012-06-08 |
| 1194002824 | Superior Physician Services Pllc | Family Medicine | 315 E Eisenhower Pkwy Ste 7, Ann Arbor, MI 48108-3329 | 2011-11-09 |
| 1629380530 | Lindsey V. Kotagal | Family Medicine | 501 N Maple Rd, Ann Arbor, MI 48103-2827 | 2010-07-08 |
| Find all providers in ANN ARBOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.