Individual
THOMAS FAUNTLEROY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27809 WAVERLY RD, EASTON, MD 21601-8123
(410) 822-5088
Mailing address
27809 WAVERLY RD, EASTON, MD 21601-8123
(410) 822-5088
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0015315
MD
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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