Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD19275 | DC |
NPI | 1033107883 |
---|---|
Provider Name | Dr. Craig Robert Faulks |
First Address | Washington, DC 20037-2356 |
Second Address | Washington, DC 20037-2356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0635400003 | DMERC (01) | DC |
44290003 | CAREFIRST/BCBS (01) | DC |
F83663 | (02) | DC |