Provider Demographics
NPI:1407326580
Name:FABER, EDMOND
Entity Type:Individual
Prefix:MR
First Name:EDMOND
Middle Name:
Last Name:FABER
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 1:3 WASHINGTON CIRCLE NW
Mailing Address - Street 2:STE 207/208
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-955-6001
Mailing Address - Fax:202-955-6008
Practice Address - Street 1:3 WASHINGTON CIRCLE NW
Practice Address - Street 2:STE 207/208
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-955-6001
Practice Address - Fax:202-955-6008
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSA0181246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant