Provider Demographics
NPI:1700683216
Name:FABULA, BRIAN ANDREW
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANDREW
Last Name:FABULA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26386-4515
Mailing Address - Country:US
Mailing Address - Phone:681-622-0284
Mailing Address - Fax:
Practice Address - Street 1:29 CHERRY ST
Practice Address - Street 2:
Practice Address - City:LUMBERPORT
Practice Address - State:WV
Practice Address - Zip Code:26386-4515
Practice Address - Country:US
Practice Address - Phone:681-622-0284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant