Provider Demographics
NPI:1285977439
Name:FETTEROLF, FRANK A (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:FETTEROLF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 SHADY AVE STE D103
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4460
Mailing Address - Country:US
Mailing Address - Phone:412-832-9949
Mailing Address - Fax:510-275-0490
Practice Address - Street 1:401 SHADY AVE STE D103
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4460
Practice Address - Country:US
Practice Address - Phone:412-832-9949
Practice Address - Fax:510-275-0490
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4583532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry