Individual
JOHN J FATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 982-5440
Mailing address
3355 GLENDALE AVE, 3RD FLOOR, TOLEDO, OH 43614-2426
(419) 383-7146
(419) 383-2050
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
4301051219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301051219
CONTROLLED SUSBSTANCE
MI
05
—
465852010
—
MI
Enumeration date
08/18/2005
Last updated
03/07/2023
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