Individual
DR. BRIAN ANDREW FAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
220 N IRONWOOD DR, SOUTH BEND, IN 46615
(574) 289-3937
(574) 280-7355
Mailing address
PO BOX 549, 835 N. CASS ST., WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003536A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201014610
—
IN
Enumeration date
07/29/2008
Last updated
08/15/2018
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