Provider Demographics
NPI:1447230560
Name:FAIRBROTHER, PAUL FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANCIS
Last Name:FAIRBROTHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 WILTON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HARTFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23071
Mailing Address - Country:US
Mailing Address - Phone:717-480-7105
Mailing Address - Fax:
Practice Address - Street 1:517 WILTON CREEK RD
Practice Address - Street 2:
Practice Address - City:HARTFIELD
Practice Address - State:VA
Practice Address - Zip Code:23071-3032
Practice Address - Country:US
Practice Address - Phone:717-480-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037786L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3432283OtherAETNA HMO PROVIDER NUMBER
PA4267790OtherAETNA PPO PROVIDER NUMBER
PA001156OtherHIGHMARK BLUE SHIELD
PA50026621OtherCAPITAL BLUE CROSS
PA50026621OtherCAPITAL BLUE CROSS
PA001156FQXMedicare ID - Type Unspecified