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NPI Code Detail

MEDICARE: SALEH A. FETOUH, M.D., PC

MEDICARE: SALEH A. FETOUH, M.D., PC
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
1261QR0206XMammography Clinic/Center

General Provider Information

NPI Number : 1346411675
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALEH A. FETOUH, M.D., PC
Provider Business Mailing Address
First Line : 2828 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14214-1722
Country : US
Telephone Number : 716-838-1300
Fax Number : 716-837-7725
Provider Business Practice Location Address
First Line : 2828 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14214-1722
Country : US
Telephone Number : 716-838-1300
Fax Number : 716-837-7725
Authorized Official
Title or Position : DIRECTOR
Name : DR. SALEH A FETOUH
Credential : MD
Telephone Number : 716-838-1300
Provider Enumeration Date : 03/14/2008
Last Update Date : 03/14/2008

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