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NPI Code Detail

MEDICARE: MICAHEL L FITZPATRICK MD

MEDICARE: MICAHEL L FITZPATRICK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician35052675FOH
2207Q00000XFamily Medicine Physician35052675FOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053382275
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICAHEL L FITZPATRICK MD
Provider Business Mailing Address
First Line : 7507 ANNIN ST
Second Line :
City : HOLLAND
State : OH
Zip : 43528-9550
Country : US
Telephone Number : 419-866-2178
Fax Number :
Provider Business Practice Location Address
First Line : 921 E FRANKLIN ST
Second Line :
City : KENTON
State : OH
Zip : 43326-2020
Country : US
Telephone Number : 419-675-8328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 03/07/2008

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