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Organization
MADONNA FABIAN MD PC
Active
Organization
MADONNA FABIAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADONNA FABIAN MEDICAL DEGREE (PRESIDENT)
(323) 547-2155
Entity
Organization
Contact information
Practice address
3078 NILES RD, SAINT JOSEPH, MI 49085-8608
(323) 547-2155
Mailing address
7320 STEVENSVILLE BARODA RD, STEVENSVILLE, MI 49127-9703
(323) 547-2155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/18/2021
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