Individual
MICHAEL J FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
105 N MEADOWS DR, ATHENS, TN 37303-4172
(423) 649-3300
Mailing address
PO BOX 220, ATHENS, TN 37371-0220
(423) 899-9080
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN9546
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3902466
—
TN
01
—
4103253
BLUE CROSS BLUE SHIELD
TN
01
—
P00216480
RR MEDICARE
TN
Enumeration date
05/20/2006
Last updated
10/30/2007
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