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Individual

PAUL FAYBUSOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
1900 CENTRACARE CIR STE 1325, SAINT CLOUD, MN 56303-5000
(320) 654-3650
(320) 654-3681
Mailing address
1900 CENTRACARE CIR STE 1325, SAINT CLOUD, MN 56303-5000
(320) 654-3650
(320) 654-3681

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
OT019251
PA
207R00000X
Internal Medicine Physician
OS020058
PA

Other

Enumeration date
04/18/2016
Last updated
04/21/2022
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