Provider Demographics
NPI:1285032763
Name:ROBY, FAIESE TAASE (MBBS)
Entity Type:Individual
Prefix:DR
First Name:FAIESE
Middle Name:TAASE
Last Name:ROBY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3965
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-3965
Mailing Address - Country:US
Mailing Address - Phone:684-699-6380
Mailing Address - Fax:684-699-6374
Practice Address - Street 1:PETESA RD, TAFUNA
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799-3965
Practice Address - Country:US
Practice Address - Phone:684-699-6380
Practice Address - Fax:684-699-6374
Is Sole Proprietor?:No
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AS2034-A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice