Provider Demographics
NPI:1659531150
Name:FAUL, JUSTIN DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:DAVID
Last Name:FAUL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15100 WASHINGTON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-4920
Mailing Address - Country:US
Mailing Address - Phone:540-274-3205
Mailing Address - Fax:833-673-0375
Practice Address - Street 1:15100 WASHINGTON ST STE 203
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-4920
Practice Address - Country:US
Practice Address - Phone:540-274-3205
Practice Address - Fax:833-673-0375
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301033213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery