Provider Demographics
NPI:1831193887
Name:FASSLER, STEVEN ADAM (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ADAM
Last Name:FASSLER
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 1:1235 OLD YORK RD
Mailing Address - Street 2:STE G20
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3839
Mailing Address - Country:US
Mailing Address - Phone:215-517-1250
Mailing Address - Fax:215-517-0821
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:STE G20
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3839
Practice Address - Country:US
Practice Address - Phone:215-517-1250
Practice Address - Fax:215-517-0821
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-073493-L208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H37590Medicare UPIN
PAFA921814Medicare ID - Type Unspecified