Provider Demographics
NPI:1902192149
Name:FAUX, PAUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:FAUX
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 METROPOLITAN PKWY
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4209
Mailing Address - Country:US
Mailing Address - Phone:586-698-1028
Mailing Address - Fax:586-698-1031
Practice Address - Street 1:2310 METROPOLITAN PKWY
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4209
Practice Address - Country:US
Practice Address - Phone:586-698-1028
Practice Address - Fax:586-698-1031
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2369343Medicaid
MI0640711314Medicare NSC