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Individual
MARLENE C FAUS
Active
Individual
MARLENE C FAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA000328L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1551917
GATEWAY HEALTH PLAN
PA
01
—
50031745
CAPITAL BLUE CROSS
PA
01
—
R06196
HEALTH ASSURANCE
PA
Enumeration date
01/16/2006
Last updated
09/24/2007
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