Individual
STEPHEN FASSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
276 MANCHESTER AVE, WABASH, IN 46992-1808
(260) 563-2126
(260) 563-2120
Mailing address
276 MANCHESTER AVE, WABASH, IN 46992-1808
(260) 563-2126
(260) 563-2120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033201
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100385440
—
IN
Enumeration date
11/01/2006
Last updated
03/21/2021
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