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NPI Code Detail

MEDICARE: PATRICK L FABRIZIO MD

MEDICARE: PATRICK L FABRIZIO 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
12085R0001XRadiation Oncology Physician4301065539MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1920005690OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356350938
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK L FABRIZIO MD
Provider Business Mailing Address
First Line : PO BOX 3525
Second Line :
City : EVANSVILLE
State : IN
Zip : 47734-3525
Country : US
Telephone Number : 616-486-5750
Fax Number : 616-486-5785
Provider Business Practice Location Address
First Line : 100 MICHIGAN ST NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 616-391-1830
Fax Number : 616-391-1286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 12/09/2025

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