Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | LT000886 | PA |
NPI | 1114596616 |
---|---|
Provider Name | Dr. Amirreza Fatehi |
First Address | Austin, TX 78705-2375 |
Second Address | Pittsburgh, PA 15237-5866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2021 |
Last Update Date | 21/06/2021 |