Healthcare Provider Details

I. General information

NPI: 1043290521
Provider Name (Legal Business Name): MARNIN ELI FISCHBACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NORTHPOINTE CIR SUITE 306
SEVEN FIELDS PA
16046-7851
US

IV. Provider business mailing address

1036 SUMMERSET DR
PITTSBURGH PA
15217-2537
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-4848
  • Fax: 724-772-4888
Mailing address:
  • Phone: 412-521-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD072287L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: