Individual
THOMAS M FABIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2625 TAMIAMI TRL, UNIT 1, PORT CHARLOTTE, FL 33952-6478
(941) 235-4646
(941) 235-4655
Mailing address
2625 TAMIAMI TRL UNIT 1, PORT CHARLOTTE, FL 33952-6403
(877) 277-4646
(941) 235-4642
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25.000270
OH
2085R0202X
Diagnostic Radiology Physician
D76130
MD
2085R0202X
Diagnostic Radiology Physician
Primary
ME46901
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00195923F
RAILROAD PROVIDER NUMBER
FL
Enumeration date
09/07/2005
Last updated
03/15/2016
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