Provider Demographics
NPI:1023049418
Name:FABER, DANIEL REY (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:REY
Last Name:FABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:280 RIVER PARK DR
Mailing Address - Street 2:#200
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-5764
Mailing Address - Country:US
Mailing Address - Phone:801-223-4860
Mailing Address - Fax:801-371-8993
Practice Address - Street 1:280 RIVER PARK DR
Practice Address - Street 2:#200
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-5764
Practice Address - Country:US
Practice Address - Phone:801-223-4860
Practice Address - Fax:801-371-8993
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166876207L00000X
UT1802048905207LA0401X, 207LP2900X
UT180204-1205208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTA52678Medicare UPIN
UT005778201Medicare ID - Type Unspecified