Individual
MATTHEW FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3205 SUMMIT SQUARE PL STE 100, LEXINGTON, KY 40509-2650
(859) 335-9041
(859) 335-9072
Mailing address
3205 SUMMIT SQUARE PL STE 100, LEXINGTON, KY 40509-2650
(859) 335-9041
(859) 335-9072
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38615
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330279
ANTHEM
KY
01
—
1069243
BWC
WV
05
—
2378958
—
OH
05
—
3810004577
—
WV
01
—
50005451
PASSPORT
KY
05
—
64079957
—
KY
01
—
P00212459
RR MEDICARE
KY
Enumeration date
07/15/2006
Last updated
12/13/2007
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