Provider Demographics
NPI:1407845621
Name:FISHBAIN, JOEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:T
Last Name:FISHBAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19251 MACK AVE
Mailing Address - Street 2:SUITE 333, THIRD FLOOR
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2893
Mailing Address - Country:US
Mailing Address - Phone:313-642-9882
Mailing Address - Fax:
Practice Address - Street 1:19251 MACK AVE
Practice Address - Street 2:SUITE 333, THIRD FLOOR
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2893
Practice Address - Country:US
Practice Address - Phone:313-642-9882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301091471207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease