Individual
MR. FAUSTO IMBING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
306 STANAFORD RD, BECKLEY, WV 25801-3142
(606) 574-8366
(606) 574-8013
Mailing address
81 BALL PARK RD, HARLAN, KY 40831-1701
(606) 574-8366
(606) 574-8011
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
19228
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104280000
—
WV
05
—
64072531
—
KY
05
—
6594529700
—
KY
Enumeration date
07/19/2005
Last updated
07/09/2007
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