Individual
BURT FAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 HOWARD AVE, BLDG 7-F, ALTOONA, PA 16601-4804
(814) 946-2328
(814) 946-7724
Mailing address
620 HOWARD AVE, BLDG 7-F, ALTOONA, PA 16601-4804
(814) 946-2328
(814) 946-7724
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD030242E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012276360001
—
PA
Enumeration date
04/26/2006
Last updated
08/09/2012
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