Individual
DR. TODD WAYNE FAUSNAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
549 FAIR ST, BLOOMSBURG, PA 17815-1419
(570) 387-2055
(570) 387-2056
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD420382
PA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
MD420382
PA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
0101267603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018752330004
—
PA
05
—
0018752330005
—
PA
05
—
0018752330006
—
PA
01
—
002616
FIRST PRIORITY HEALTH
PA
01
—
1470448
HIGHMARK BLUE SHIELD
PA
01
—
2517565
UNITEDHEALTHCARE
PA
01
—
6528
GEISINGER HEALTH PLAN
PA
01
—
7379443
AETNA
PA
01
—
816892
FIRST PRIORITY HEALTH
PA
01
—
H80482
HEALTHAMERICA
PA
Enumeration date
03/10/2006
Last updated
03/29/2023
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