Individual
DR. FABIO LOPES DORVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1130 DELAWARE AVE, FOUNTAIN HILL, PA 18015-4117
(610) 868-2710
(610) 868-6130
Mailing address
1130 DELAWARE AVE, FOUNTAIN HILL, PA 18015-4117
(610) 868-2710
(610) 868-6130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD037390-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109772
BLUE SHIELD
PA
Enumeration date
05/09/2006
Last updated
08/09/2007
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