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Individual

DR. RUSSELL A. FAUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1200 N TELEGRAPH RD, PONTIAC, MI 48341-0432
(248) 858-1276
(248) 452-9754
Mailing address
1200 N TELEGRAPH RD, PONTIAC, MI 48341-0432
(248) 858-1276
(248) 452-9754

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301079386
MI
2086S0120X
Pediatric Surgery Physician
35088248
OH

Other

Enumeration date
11/02/2006
Last updated
08/28/2019
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