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Organization
A.W.C. FAIRCLOUGH MD PC
Active
Organization
A.W.C. FAIRCLOUGH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY FARICLOUGH MD (PRESIDENT)
(248) 334-4773
Entity
Organization
Contact information
Practice address
989 UNIVERSITY DR, SUITE 107, PONTIAC, MI 48342-1885
(248) 334-4773
(248) 334-8230
Mailing address
989 UNIVERSITY DR, SUITE 107, PONTIAC, MI 48342-1885
(248) 334-4773
(248) 334-8230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AF036119
MI
207RG0100X
Gastroenterology Physician
AF036119
MI
Other
Enumeration date
05/10/2010
Last updated
07/27/2010
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