Individual
JARRET FAUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 RIVERSIDE CIR STE 300, ROANOKE, VA 24016-4962
(540) 581-0170
(479) 966-4979
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5705
(479) 966-4979
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA-1175
AR
363A00000X
Physician Assistant
Primary
0110009727
VA
Other
Enumeration date
08/06/2020
Last updated
03/27/2024
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