Provider Demographics
NPI:1700904273
Name:FAUST, PAUL D (ND FABNO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:FAUST
Suffix:
Gender:M
Credentials:ND FABNO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 GLENEAGLES CT # 42242
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2205
Mailing Address - Country:US
Mailing Address - Phone:410-821-1788
Mailing Address - Fax:866-309-3165
Practice Address - Street 1:808 GLENEAGLES CT # 42242
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2205
Practice Address - Country:US
Practice Address - Phone:410-821-1788
Practice Address - Fax:866-309-3165
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDJ0000001175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1467813360Medicaid