Individual
MRS. LUISA FABELLA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
195 WADSWORTH RD, WADSWORTH, OH 44281-9504
(313) 253-0628
(330) 628-5572
Mailing address
PO BOX 367, MOGADORE, OH 44260-0367
(330) 628-1325
(330) 628-5572
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35035201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199860
—
OH
Enumeration date
08/23/2005
Last updated
07/08/2007
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