Individual
ELISA M FAYBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3048 E BASELINE RD, SUITE 105, MESA, AZ 85204-7286
(480) 545-6060
(480) 632-0467
Mailing address
3020 E CAMELBACK RD, SUITE 301, PHOENIX, AZ 85016-5095
(480) 545-6060
(480) 632-0467
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
33833
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33833
STATE LICENSE NUMBER
AZ
Enumeration date
09/13/2006
Last updated
02/16/2017
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