Provider Demographics
NPI:1497384002
Name:FOX, NATHANIEL ZANE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:ZANE
Last Name:FOX
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 1:901 WALNUT ST FL 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5214
Mailing Address - Country:US
Mailing Address - Phone:215-955-9425
Mailing Address - Fax:215-503-4347
Practice Address - Street 1:901 WALNUT ST FL 4
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5214
Practice Address - Country:US
Practice Address - Phone:215-955-9425
Practice Address - Fax:215-503-4347
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program