Provider Demographics
NPI:1154500015
Name:DR H FAIZ AND ASSOCIATES SURGICAL CLINIC INC
Entity Type:Organization
Organization Name:DR H FAIZ AND ASSOCIATES SURGICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-546-5488
Mailing Address - Street 1:1800 COMBS RD STE 2
Mailing Address - Street 2:PO BOX 606
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-1808
Mailing Address - Country:US
Mailing Address - Phone:276-546-5488
Mailing Address - Fax:276-546-4636
Practice Address - Street 1:1800 COMBS RD STE 2
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-1808
Practice Address - Country:US
Practice Address - Phone:276-546-5488
Practice Address - Fax:276-546-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC01693Medicare PIN