Provider Demographics
NPI:1518159276
Name:FAKHRI, ABID ALI (MD)
Entity Type:Individual
Prefix:
First Name:ABID
Middle Name:ALI
Last Name:FAKHRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:1 MELLON WAY
Practice Address - Street 2:LATROBE AREA HOSPITAL
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1197
Practice Address - Country:US
Practice Address - Phone:724-539-6320
Practice Address - Fax:724-539-6333
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2018-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD84569207RC0000X
PAMD438800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028223710001Medicaid
PA1028223710001Medicaid