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General NPI Number Information
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NPI Number | 1437896255
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Entity Type | Individual
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Provider Name | MATTHEW JOHN FABBRO MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2022
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 550 OSBORN BLVD STE 1006
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City | SAULT SAINTE MARIE
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State | MI
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Zip | 49783-1899
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Country | US
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Telephone | 906-253-2665
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Fax | 906-253-2670
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Provider Business Mailing Address
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Address Line | 4000 WELLNESS DR
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City | MIDLAND
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State | MI
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Zip | 48670-2000
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Country | US
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Telephone | 844-832-1956
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Fax | 989-633-5241
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301514865
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License Number State | MI
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