Individual
DAVID R FAKIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
018933
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548194
ANTHEM-KCR
KY
01
—
02880871
NY MEDICAL ASSISTANCE
NY
01
—
101918790
MEDICAL ASSISTANCE PA
PA
05
—
101918790
—
PA
05
—
1019187900001
—
PA
01
—
1071748
WV WORKERS COMP
WV
05
—
1467458927
—
VA
01
—
1563209
GATEWAY
PA
01
—
1564931
AETNA
PA
05
—
1909173
—
LA
01
—
211195701
TPI
TX
01
—
219107
UNISON
PA
01
—
2750303
OH MEDICAL ASSISTANCE
OH
05
—
2750303
—
OH
01
—
3425392000
PASSPORT ADVANTAGE
KY
01
—
3810010518
MEDICAID WV
VA
01
—
50017540
PASSPORT-KCR
KY
01
—
705750
BLUE SHIELD
PA
05
—
7100028580
—
KY
01
—
91729
SIHO-KCR
KY
01
—
P00405860
MEDICARE RAILROAD
VA
Enumeration date
06/21/2005
Last updated
02/26/2015
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