Individual
PETER M FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1116A THOMAS RD, WARRINGTON, PA 18976-1842
(215) 343-4573
Mailing address
1116A THOMAS RD, WARRINGTON, PA 18976-1842
(215) 343-4573
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC-004353-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0673679000
IBC
—
01
—
778054
BC/BS
—
01
—
P00184568
RR MEDICARE
—
Enumeration date
09/25/2006
Last updated
02/26/2015
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