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NPI 1356350938

NPI 1356350938 : PATRICK L FABRIZIO MD : GRAND RAPIDS, MI

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General NPI Number Information
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    NPI Number           |    1356350938
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICK L FABRIZIO MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/05/2006
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    Last Update Date     |    12/09/2025
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Provider Practice Location Address
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    Address Line         |    100 MICHIGAN ST NE 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49503-2560
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    Country              |    US
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    Telephone            |    616-391-1830
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    Fax                  |    616-391-1286
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Provider Business Mailing Address
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    Address Line         |    PO BOX 3525 
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    City                 |    EVANSVILLE
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    State                |    IN
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    Zip                  |    47734-3525
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    Country              |    US
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    Telephone            |    616-486-5750
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    Fax                  |    616-486-5785
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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        |    2085R0001X
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    Taxonomy Name        |    Radiation Oncology Physician
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    License Number       |    4301065539
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    License Number State |    MI
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