Individual
RANDY J FAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
744 W MICHIGAN AVE, JACKSON, MI 49201-1909
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101014557
MI
Other
Enumeration date
06/10/2006
Last updated
12/28/2016
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