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General NPI Number Information
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NPI Number | 1891857728
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Entity Type | Individual
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Provider Name | FORTUNATO R MACATOL MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 401 MATTHEW ST
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City | MARIETTA
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State | OH
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Zip | 45750-1635
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Country | US
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Telephone | 740-374-1499
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Fax | 740-374-1766
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Provider Business Mailing Address
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Address Line | PO BOX 23
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-8790
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Fax | 740-374-1766
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 35035999
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 15831
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License Number State | WV
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