Provider Demographics
NPI:1700851789
Name:FUCHS, MICHAEL IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:IRA
Last Name:FUCHS
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 1:1225 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3050
Mailing Address - Country:US
Mailing Address - Phone:718-436-9649
Mailing Address - Fax:718-436-6080
Practice Address - Street 1:1225 49TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3050
Practice Address - Country:US
Practice Address - Phone:718-436-9649
Practice Address - Fax:718-436-6080
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143035207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00825127Medicaid
NY00825127Medicaid