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General NPI Number Information
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NPI Number | 1437142593
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Entity Type | Individual
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Provider Name | BARRY M FABIUS MD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8580 VERREE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19111-1370
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Country | US
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Telephone | 215-214-2891
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Fax | 215-214-2894
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Provider Business Mailing Address
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Address Line | 12265 TOWNSEND RD SUITE 500
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City | PHILADELPHIA
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State | PA
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Zip | 19154-1201
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Country | US
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Telephone | 215-856-1009
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Fax | 215-856-1020
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD036113E
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License Number State | PA
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