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General NPI Number Information
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NPI Number | 1326227588
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Entity Type | Individual
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Provider Name | JOSEPH P FAHEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 22 HARTFORD ST
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City | HOULTON
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State | ME
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Zip | 04730-1844
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Country | US
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Telephone | 207-532-2234
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Fax | 207-532-2234
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Provider Business Mailing Address
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Address Line | 22 HARTFORD ST SUITE 201
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City | HOULTON
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State | ME
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Zip | 04730-1844
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Country | US
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Telephone | 207-532-2234
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Fax | 207-532-2235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 58269
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD17732
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 038331
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License Number State | CT
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