Individual
COREY RICHARD FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1076 W MCPHERSON HWY, CLYDE, OH 43410-1133
(419) 547-0216
(419) 547-9130
Mailing address
1400 W MAIN ST, BUILDING 1 SUITE A, BELLEVUE, OH 44811-9088
(419) 483-2494
(419) 483-3224
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34009034
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2765315
—
OH
Enumeration date
07/11/2007
Last updated
11/19/2008
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