# A.W.C. FAIRCLOUGH MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104144526
- **Authorized official:** DR. ANTHONY FARICLOUGH MD (PRESIDENT)
- **Authorized official phone:** (248) 334-4773

## Contact information

- **Practice address:** 989 UNIVERSITY DR, SUITE 107, PONTIAC, MI 48342-1885
- **Practice address phone:** (248) 334-4773
- **Practice address fax:** (248) 334-8230
- **Mailing address:** 989 UNIVERSITY DR, SUITE 107, PONTIAC, MI 48342-1885
- **Mailing address phone:** (248) 334-4773
- **Mailing address fax:** (248) 334-8230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | AF036119 | MI | Yes |
| 207RG0100X | Gastroenterology Physician | AF036119 | MI | — |

## Other

- **Enumeration date:** 05/10/2010
- **Last updated:** 07/27/2010