Provider Demographics
NPI:1598224222
Name:FAULK, ANDREW MARKUS
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARKUS
Last Name:FAULK
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 1:2121 WEBSTER ST APT 605
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-7812
Mailing Address - Country:US
Mailing Address - Phone:415-827-2120
Mailing Address - Fax:
Practice Address - Street 1:2121 WEBSTER ST APT 605
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-7812
Practice Address - Country:US
Practice Address - Phone:415-827-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56078207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease