DR. THEODORE W. FETTER (NPI# 1740213891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740213891 |
| Entity Type | Individual |
| Full Name | DR. THEODORE W. FETTER |
| Credential | M.D. |
| Practice Address |
201 Park St Se Vienna VA 22180-4644 |
| Mailing Address |
8204 Hackamore Dr Potomac MD 20854-3874 |
| Practice Telephone | 7033561465 |
| Practice Fax Number | 3019835856 |
| Mailing Telephone | 3012997096 |
| Mailing Fax Number | 3019835856 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
D44922 | MD | Allopathic & Osteopathic Physicians |
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
0101047649 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 085754 | 01 |
| VA | 6501036 | 05 | |
| DC | CAREFIRST BC BS | B421-0001 | 01 |
| MD | CAREFIRST BC BS | 2207TW | 01 |
| Street Address |
201 PARK ST SE |
| City | VIENNA |
| State | VA |
| Zip Code | 22180-4644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255334249 | Elizabeth Mcguire Hoehl | Audiologist | 201 Park St Se, Vienna, VA 22180-4644 | 2005-05-23 |
| 1679183206 | The Vienna Hearing Center, Inc. | Audiologist-Hearing Aid Fitter | 201 Park St Se, Vienna, VA 22180-4661 | 2020-08-07 |
| 1689812133 | Robert P Sileo Md PC | Internal Medicine | 201 Park St Se, Vienna, VA 22180-4661 | 2009-01-21 |
| 1316198559 | Dr. Daniel D. Rooney, Ltd. | Specialist | 201 Park St Se, Vienna, VA 22180-4661 | 2008-10-07 |
| 1386806651 | Vienna-fair Oaks Hearing and Speech Center, Inc. | Audiologist | 201 Park St Se, Vienna, VA 22180-4661 | 2008-06-27 |
| 1073561148 | Catherine Watson | Audiologist | 201 Park St Se, Vienna, VA 22180-4644 | 2006-05-04 |
| 1629040001 | Robert P Sileo | Internal Medicine | 201 Park St Se, Vienna, VA 22180-4644 | 2006-02-01 |
| 1649261637 | Daniel Dare Rooney | Otolaryngology | 201 Park St Se, Vienna, VA 22180-4644 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023519386 | Erika Ruiz | Dentist | Ave Miraflores #6439 - A, Tijuana, BAJA CALIFORNIA 22180 | 2018-02-22 |
| 1992220206 | John Alexander | Massage Therapist | 122 Maple Ave W, Vienna, VA 22180 | 2017-08-08 |
| 1548620214 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 2675 Avenir Place, Vienna, VA 22180 | 2016-02-24 |
| 1992163190 | Peter J Mcgarry | Chiropractor | 301 Maple Ave. W. Ste 515, Vienna, VA 22180 | 2016-02-02 |
| 1629479563 | Jaimie Vettichira Samuel | Pediatrics | 100 East St Se Ste 301, Vienna, VA 22180 | 2014-09-10 |
| 1326454562 | N R Emad Dds PC | Dentist | 307 F Maple Ave. W #100, Vienna, VA 22180 | 2014-07-09 |
| 1881020568 | Albert Juan Garcia | Obstetrics & Gynecology | 926 Fairway Dr., N.e., Vienna, VA 22180 | 2013-09-25 |
| 1295174662 | Sallie Twentyman | Social Worker | 129 Park St Ne Ste 12b, Vienna, VA 22180 | 2013-06-19 |
| 1124390992 | Gilda T. Clarke | Counselor | 133 Park St. Ne, Vienna, VA 22180 | 2012-02-08 |
| 1740573898 | Metro Eyes LLC | Technician/Technologist | 256 E Maple Avenue, Vienna, VA 22180 | 2011-05-24 |
| Find all providers in zip 22180 | ||||
| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326596479 | Washington Ear Associates Pllc | Otolaryngology | 1093 Bonnie View Dr, Great Falls, VA 22066-1821 | 2016-09-19 |
| 1841522430 | The Center for Dizziness and Balance Disorders, P.C. | Otolaryngology | 1524 Apperson Dr, Salem, VA 24153-7219 | 2010-02-05 |
| 1770509879 | Peter L Rigby | Otolaryngology | 161 Wadsworth Dr, Richmond, VA 23236-4500 | 2006-07-14 |
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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.