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1457348310

NPI Code Detail

MEDICARE: DR. FABIAN NWADEI MD

MEDICARE: DR. FABIAN NWADEI 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
1	207R00000X	Internal Medicine Physician	C128694	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1457348310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FABIAN NWADEI MD

Provider Business Mailing Address
First Line	:	45 E RIVER PARK PL W STE 507
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-1565
Country	:	US
Telephone Number	:	559-603-7367
Fax Number	:	559-603-7366

Provider Business Practice Location Address
First Line	:	2823 FRESNO ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93721-1324
Country	:	US
Telephone Number	:	559-459-6000
Fax Number	:	559-603-7366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	06/03/2024

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Directions to “ DR. FABIAN NWADEI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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