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Individual

EDWIN FAHEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6825 DIXIE HWY, CLARKSTON, MI 48346
(248) 625-6820
(248) 625-6821
Mailing address
6825 DIXIE HWY, CLARKSTON, MI 48346
(248) 625-6820
(248) 625-6821

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501000708
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
650F300730
BCBS
MI
Enumeration date
02/14/2007
Last updated
08/09/2010
About Stedi
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  • EDI platform