Organization
FAYETTE SPECIALTY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NABIL G ELKHOURY MD (PHYSICIAN-DIRECTOR)
(724) 434-1200
Entity
Organization
Contact information
Practice address
112 YOUNGSTOWN RD, SUITE 102, LEMONT FURNACE, PA 15456-1344
(724) 434-1650
(724) 434-1659
Mailing address
100 MATTHEW DR, UNIONTOWN, PA 15401-8418
(724) 434-1200
(724) 434-1600
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD439306
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188053R6L
MEDICARE PTAN
PA
Enumeration date
11/02/2010
Last updated
11/02/2010
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