Provider Demographics
NPI:1215497607
Name:FABIAN, MICHELE ANN (PA-C)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:FABIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARK WEST BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4226
Mailing Address - Country:US
Mailing Address - Phone:330-835-5533
Mailing Address - Fax:
Practice Address - Street 1:1 PARK WEST BLVD STE 330
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4226
Practice Address - Country:US
Practice Address - Phone:330-835-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant