Donald Edward Fetterolf, MD, MBA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD023825-E Issued in PA

Practice address

12 Laurel Hill Rd
MC Donald, PA 15057-3503

Phone

(412) 638-2891

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1730249749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "city": "IMPERIAL",
            "state": "PA",
            "postal_code": "151260246",
            "telephone_number": "412-638-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LAUREL HILL RD",
            "city": "MC DONALD",
            "state": "PA",
            "postal_code": "150573503",
            "telephone_number": "412-638-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTEROLF",
        "first_name": "DONALD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD023825-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE NUMBER",
            "identifier": "MD023825E",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE NUMBER",
            "identifier": "058175",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Dudley, PHARMD
• Katie Anne Dugan, COTA/L
• Alfred Dunn, FNP
• Family Owned Pharmacies of PA LLC
• Family Owned Pharmacies of PA LLC
• Fort Cherry Ambulance Inc
• Fort Cherry School District
• Breauna Shanice Franklin
• Giant Eagle Inc
• Jessica M Gilbert, SLP

• Internal Medicine Physician in MC Donald, PA
• Providers in MC Donald, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.