| Madonna Fabian Md Pc | |
|
3078 Niles Rd Saint Joseph MI 49085-8608 | |
| (323) 547-2155 | |
| Not Available |
| Full Name | Madonna Fabian Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3078 Niles Rd, Saint Joseph, Michigan |
| Authorized Official Name and Position | Madonna Fabian (PRESIDENT) |
| Authorized Official Contact | 3235472155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madonna Fabian Md Pc 7320 Stevensville Baroda Rd Stevensville MI 49127-9703 Ph: (323) 547-2155 | Madonna Fabian Md Pc 3078 Niles Rd Saint Joseph MI 49085-8608 Ph: (323) 547-2155 |
| NPI Number | 1174106652 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 05/18/2021 |
| Medicare PECOS PAC ID | 2163822438 |
|---|---|
| Medicare Enrollment ID | O20210609000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174106652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Madonna Fabian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124438411 PECOS PAC ID: 9931470754 Enrollment ID: I20210609000606 |
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