Individual
DR. FAISAL THALJEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W BOUNDARY AVE, WINNFIELD, LA 71483-3427
(318) 747-1007
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14353R
LA
207R00000X
Internal Medicine Physician
MD.14353R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1049077
—
LA
01
—
P00979659
RRMCARE THRU GPN MANY
LA
Enumeration date
05/21/2006
Last updated
01/06/2012
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