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Individual

DR. GREGORY G FAIMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2610 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 858-2610
(316) 858-2793
Mailing address
3800 E 93RD ST N, VALLEY CENTER, KS 67147-8716
(316) 650-2878

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0427023
KS
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
04-27023
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100294640H
KS
05
100294640L
KS
05
100294640M
KS
05
100294640W
KS
01
105234
BC/BS OF KANSAS
KS
05
200362720C
KS
01
P00615213
RR MC (PALMETTO)
KS
Enumeration date
08/21/2006
Last updated
12/22/2016
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