Provider Demographics
NPI:1326163981
Name:FABER, EDWARD ANTHONY JR (DO, MS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ANTHONY
Last Name:FABER
Suffix:JR
Gender:M
Credentials:DO, MS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2145
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:4777 E GALBRAITH RD
Practice Address - Street 2:STE 320
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2725
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-793-6290
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.011025207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089608Medicaid
IN201182000Medicaid
OH0089608Medicaid