Provider Demographics
NPI:1952511503
Name:FAUST, H GREG (DC)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:GREG
Last Name:FAUST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7010 PHOENIX AVE
Mailing Address - Street 2:SUITE # 509
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3506
Mailing Address - Country:US
Mailing Address - Phone:505-883-0757
Mailing Address - Fax:
Practice Address - Street 1:9204 MENAUL BLVD. NE
Practice Address - Street 2:SUITE # 4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2201
Practice Address - Country:US
Practice Address - Phone:505-888-2488
Practice Address - Fax:505-881-5087
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM1526111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology