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1790834828
ELBERT A FASNACHT
CARBONDALE, IL
NPI
1790834828
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 036075250)
Enumeration Date
2007-01-09
Last Update Date
2009-09-10
Business Address
-- ELBERT A FASNACHT MD
721 S LEWIS LN
CARBONDALE, IL 62901-3344
Phone number: 618-457-4999
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Mailing Address
-- ELBERT A FASNACHT MD
721 S LEWIS LN
CARBONDALE, IL 62901-3344
Phone number: 618-457-4999
Copy
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