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Individual

DR. EMMANUEL K. FAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, PHD

Contact information

Practice address
8118 GOOD LUCK RD, LANHAM, MD 20706-3574
(301) 552-8130
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0004092
MD
363A00000X
Physician Assistant
Primary
PA2024-0084
NM
363AS0400X
Surgical Physician Assistant
CO4092
MD

Other

Enumeration date
01/14/2010
Last updated
01/21/2025
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