Organization
DEO GRACIAS FAUSTINO MD PA
Active
Other names
Deogracias V. Faustino (solo practice)
Organization subpart
No
Provider details
NPI number
Authorized official
DEOGRACIAS FAUSTINO MD (INTERNIST)
(410) 374-4488
Entity
Organization
Contact information
Practice address
4111 LOWER BECKLEYSVILLE RD, HAMPSTEAD, MD 21074-2248
(410) 374-4488
Mailing address
PO BOX 698, HAMPSTEAD, MD 21074-0698
(410) 374-4488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0012901
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009431500
—
MD
01
—
1164504528
SOLO PRACTICE NPI AS DEOGRACIAS V. FAUSTINO, M.D.
MD
01
—
D0012901
DMHMH LICENSE NO.
MD
Enumeration date
05/26/2010
Last updated
03/07/2023
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