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General NPI Number Information
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NPI Number | 1790748721
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Entity Type | Individual
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Provider Name | MICHELINA FATO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 5230 CENTRE AVE 5TH FLOOR
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City | PITTSBURGH
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State | PA
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Zip | 15232-1304
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Country | US
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Telephone | 412-623-3351
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Fax | 412-623-3360
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Provider Business Mailing Address
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Address Line | 2 HOT METAL ST QUANTUM ONE, N430
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City | PITTSBURGH
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State | PA
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Zip | 15203-2348
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Country | US
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Telephone | 412-432-7706
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Fax | 412-432-7691
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD 040123 E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | MD 040123 E
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD 040123 E
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License Number State | PA
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