Provider Demographics
NPI:1063481257
Name:FAITH, DONALD J (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:FAITH
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 1:95 LEONARD AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-223-3100
Mailing Address - Fax:724-223-3353
Practice Address - Street 1:3415 MILLERS RUN RD
Practice Address - Street 2:
Practice Address - City:CECIL
Practice Address - State:PA
Practice Address - Zip Code:15321-1403
Practice Address - Country:US
Practice Address - Phone:724-873-7414
Practice Address - Fax:724-872-7421
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
115420OtherUNISON
000121504OtherHIGHMARK
P002109OtherGATEWAY
PA0017108050003Medicaid
207489OtherUPMC
P002109OtherGATEWAY
H05805Medicare UPIN
115420OtherUNISON