Individual
DR. MICHAEL A FACKTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-1339
(570) 271-6259
(570) 271-7833
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD433557
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020738040001
—
PA
Enumeration date
12/01/2005
Last updated
07/30/2020
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