Provider Demographics
NPI:1902851058
Name:FABREY, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:FABREY
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 1:800 COMPTON RD
Mailing Address - Street 2:UNIT 24
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3826
Mailing Address - Country:US
Mailing Address - Phone:513-521-5333
Mailing Address - Fax:513-521-5334
Practice Address - Street 1:800 COMPTON RD
Practice Address - Street 2:UNIT 24
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3826
Practice Address - Country:US
Practice Address - Phone:513-521-5333
Practice Address - Fax:513-521-5334
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35040436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0366241Medicaid
OHA76130Medicare UPIN
OH0366241Medicaid