Individual
MICHAEL S FAKHRAEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7500 CENTRAL AVE, SUITE 101, PHILADELPHIA, PA 19111-2431
(215) 728-8200
(215) 725-3209
Mailing address
7500 CENTRAL AVE, SUITE 101, PHILADELPHIA, PA 19111-2431
(215) 728-8200
(215) 725-3209
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
MD018776E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052487000
KEYSONE HEALTH PLAN EAST
PA
01
—
400138
BLUE CROSS &BLUE SHIELD
PA
Enumeration date
06/22/2006
Last updated
02/29/2008
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