Individual
DR. SHOKAT M FATTEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8166 MARKET ST, SUITE D, YOUNGSTOWN, OH 44512-6262
(330) 953-3242
(330) 953-3243
Mailing address
2840 APPALOOSA DR, HUBBARD, OH 44425-2735
(330) 884-3803
(330) 884-3790
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
35-04-8777
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35048777
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0782854
—
OH
01
—
35-04-8777
OHIO LICENSE NUMBER
OH
Enumeration date
10/31/2005
Last updated
08/11/2010
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