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Organization
MICHAEL E FATH, D.O., P.C
Active
Organization
MICHAEL E FATH, D.O., P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E FATH D.O. (CEO/PRESIDENT)
(570) 718-8676
Entity
Organization
Contact information
Practice address
575 PIERCE ST STE 101, KINGSTON, PA 18704-5700
(570) 718-8676
(570) 338-2345
Mailing address
575 PIERCE ST STE 101, KINGSTON, PA 18704-5700
(570) 338-2345
(570) 718-8676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS012073
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038359820001
—
PA
01
—
4505879
HIGHMRK
—
Enumeration date
03/14/2008
Last updated
01/22/2021
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