Provider Demographics
NPI:1609119676
Name:FIDACARO, GEORGE ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ANTHONY
Last Name:FIDACARO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:UPMC ALTOONA
Mailing Address - Street 2:620 HOWARD AVENUE
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601
Mailing Address - Country:US
Mailing Address - Phone:814-889-2866
Mailing Address - Fax:814-889-6785
Practice Address - Street 1:UPMC ALTOONA
Practice Address - Street 2:620 HOWARD AVENUE
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-1660
Practice Address - Country:US
Practice Address - Phone:814-889-2866
Practice Address - Fax:814-889-6785
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2024-03-19
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09876900207P00000X
NY285361207P00000X
PAMD458892207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine