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Contact Information

BRUCE L FETTERMAN, MD
7600 WOLF RIVER BLVD
SUITE 220
GERMANTOWN, TN38138-1785
 Phone: 901-755-5300
 Fax: 901-756-0196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otology & Neurotology

207YX0901X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for BRUCE L FETTERMAN · (Male)

NPI Number 1699881052
Status Active
Credentials MD
Entity Individual
Enumeration date 08/21/2006
Last updated 12/17/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • TN License # MD29959
  • TN Medicaid 3818743
  • AR Other 97772 BC
  • TN Other 4108473 BC
  • TN Other P00238841 RR MEDICARE
Hospital affiliation(s)
  • BAPTIST MEMORIAL HOSPITAL - (Acute Care)
    6019 WALNUT GROVE ROAD
    MEMPHIS, TN 38120
  • METHODIST HEALTHCARE MEMPHIS HOSPITALS - (Acute Care)
    1265 UNION AVE SUITE 700
    MEMPHIS, TN 38104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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