Individual
ANTHONY G FABAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5 N ATKINSON DR, SUITE 304, LUDINGTON, MI 49431-2918
(231) 843-2600
(231) 843-2665
Mailing address
5 N ATKINSON DR STE 304, LUDINGTON, MI 49431-2918
(231) 843-2600
(231) 843-2665
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
5101006766
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
AF006766
MI
Other
Enumeration date
12/18/2006
Last updated
08/23/2011
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