Individual
FADY HENEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 MARY ST, WAYCROSS, GA 31503
(734) 819-4211
Mailing address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-7115
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
075763
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175212D
—
GA
Enumeration date
07/30/2012
Last updated
07/30/2018
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