Bradley Christopher Fetzer, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Philadelphia, Pennsylvania. His current practice location is
3400 Spruce St, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(215) 662-2200.
Bradley Christopher Fetzer is licensed to practice in Pennsylvania (license number MT197605) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164740080.
Physician's Profile
Full Name | Bradley Christopher Fetzer |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3400 Spruce St, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164740080
- Provider Enumeration Date: 05/17/2010
- Last Update Date: 05/17/2010
Medicare PECOS Information:
- PECOS PAC ID: 5799009734
- Enrollment ID: I20150121001604
Medical Identifiers
Medical identifiers for Bradley Christopher Fetzer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164740080 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | MT197605 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | MT197605 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bradley Christopher Fetzer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bradley Christopher Fetzer, MD 3400 Spruce St, Philadelphia, PA 19104-4206 Ph: (215) 662-2200 | Bradley Christopher Fetzer, MD 3400 Spruce St, Philadelphia, PA 19104-4206 Ph: (215) 662-2200 |
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