Provider Demographics
NPI:1790994622
Name:FAIZ, SABA (MD)
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:FAIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HIGHLANDS DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7507
Mailing Address - Country:US
Mailing Address - Phone:717-568-8886
Mailing Address - Fax:717-627-2727
Practice Address - Street 1:1575 HIGHLANDS DR
Practice Address - Street 2:SUITE 206
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7507
Practice Address - Country:US
Practice Address - Phone:717-568-8886
Practice Address - Fax:717-627-2727
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443462207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1073730OtherBRICKSTREET WV COMP
WV3024519OtherCIGNA
OH2914672Medicaid
WV3810012937Medicaid
PA102656252-0001Medicaid
WVFA4254051Medicare PIN
PA102656252-0001Medicaid
WV3810012937Medicaid