Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 34-001716 | OH |
NPI | 1528241072 |
---|---|
Provider Name | Dr. George Oswald Faerber |
First Address | Delaware, OH 43015-9237 |
Second Address | Delaware, OH 43015-9237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2007 |
Last Update Date | 06/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0221585 | (05) | OH |
A68403 | (02) | OH |