Individual
JOSEPH MICHAEL FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
206 SIERRA CT, METAIRIE, LA 70001
(504) 834-1311
(504) 834-1329
Mailing address
4021 RIDGEWAY DR, METAIRIE, LA 70002
(504) 834-2404
(504) 835-7262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD014350
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17734355
—
LA
Enumeration date
04/16/2007
Last updated
07/08/2007
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