1760897573 NPI number — HOWARD B FUCHS MD

Table of content: (NPI 1760897573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760897573 NPI number — HOWARD B FUCHS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD B FUCHS MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760897573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3920 BEE RIDGE RD
Provider Second Line Business Mailing Address:
BLDG B SUITE A
Provider Business Mailing Address City Name:
SARASOTA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34233-1207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-923-3495
Provider Business Mailing Address Fax Number:
941-925-8788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3920 BEE RIDGE RD
Provider Second Line Business Practice Location Address:
BLDG B SUITE A
Provider Business Practice Location Address City Name:
SARASOTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34233-1207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-923-3495
Provider Business Practice Location Address Fax Number:
941-925-8788
Provider Enumeration Date:
07/01/2014

Additional Information

Authorized Official

Authorized Official Last Name:
FUCHS
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
941-923-3495

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME42119 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 049080600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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