Provider Demographics
NPI:1063586337
Name:FABIAN, ROBERT P (DC, BS, CCEP)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:FABIAN
Suffix:
Gender:M
Credentials:DC, BS, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 WATER LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2900
Mailing Address - Country:US
Mailing Address - Phone:814-445-7170
Mailing Address - Fax:
Practice Address - Street 1:1744 WATER LEVEL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2900
Practice Address - Country:US
Practice Address - Phone:814-445-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005499L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001448020002OtherACCESS
PA716048OtherHIGHMARK
PA1501587OtherGATEWAY
PA252702OtherUPMC
PA2104234OtherUNITED HEALTH CARE
PAU47982Medicare UPIN