Individual
DR. DALE E FAHIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.F.A.C.O.F.P.
Contact information
Practice address
4600 NORTH FEDERAL HIGHWAY, FOY'S MEDICAL CENTER, FORT LAUDERDALE, FL 33308-5206
(954) 202-9948
(954) 202-7399
Mailing address
17320 SW 32ND CT, MIRAMAR, FL 33029-5591
(954) 202-9948
(954) 202-7399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS-06925
FL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
OS-6925
FL
207QA0505X
Adult Medicine Physician
OS-6925
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
OS-6925
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073790333
N.A.F.F.I. DBA FOY'S MEDICAL CENTER
FL
05
—
251207600
—
FL
01
—
592115487
TAX ID N.A.F.F.I. INC DBA
FL
Enumeration date
05/20/2006
Last updated
02/06/2013
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