Provider Demographics
NPI:1548253511
Name:FITTERER, JOSEPH DUNCAN (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DUNCAN
Last Name:FITTERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:DUNCAN
Other - Last Name:FITTERER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:105 W 8TH AVE
Mailing Address - Street 2:SUITE 6050
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2302
Mailing Address - Country:US
Mailing Address - Phone:509-747-0143
Mailing Address - Fax:509-744-1571
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 6050
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2302
Practice Address - Country:US
Practice Address - Phone:509-747-0143
Practice Address - Fax:509-744-1571
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00014953207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8145104Medicaid
WAAB03687Medicare ID - Type Unspecified
A07787Medicare UPIN