Provider Demographics
NPI:1952473092
Name:FASUSI, PATRICK O (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:O
Last Name:FASUSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6323 GEORGIA AVE NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1101
Mailing Address - Country:US
Mailing Address - Phone:202-291-0126
Mailing Address - Fax:202-291-0370
Practice Address - Street 1:6323 GEORGIA AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1101
Practice Address - Country:US
Practice Address - Phone:202-291-0126
Practice Address - Fax:202-291-0370
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD16434207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E63772Medicare UPIN