Individual
JAMES C FAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1810 E 19TH ST, SUITE 209, THE DALLES, OR 97058-3388
(541) 296-5657
Mailing address
1810 E 19TH ST, SUITE 209, THE DALLES, OR 97058-3388
(541) 296-5657
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD18414
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070875
—
OR
Enumeration date
11/14/2005
Last updated
02/27/2008
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