Provider Demographics
NPI:1134514508
Name:FAIRMAN, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FAIRMAN
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 1:17345 FALLING CREEK AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-8874
Mailing Address - Country:US
Mailing Address - Phone:303-984-1856
Mailing Address - Fax:303-922-4640
Practice Address - Street 1:17345 FALLING CREEK AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-8874
Practice Address - Country:US
Practice Address - Phone:303-984-1856
Practice Address - Fax:303-922-4640
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic