Provider Demographics
NPI:1659631513
Name:FAIGIN, DAVID A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:FAIGIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STATE RD
Mailing Address - Street 2:STE 9-1015
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-6017
Mailing Address - Country:US
Mailing Address - Phone:207-447-3007
Mailing Address - Fax:207-447-3007
Practice Address - Street 1:10 STATE RD STE 9-1015
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-6017
Practice Address - Country:US
Practice Address - Phone:207-447-3007
Practice Address - Fax:207-872-5888
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPS1346OtherSTATE