Individual
GERALD ALAN FAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45 E CITY AVE, SUITE 455, BALA CYNWYD, PA 19004-2421
(610) 969-8755
Mailing address
45 E CITY AVE, SUITE 455, BALA CYNWYD, PA 19004-2421
(610) 969-8755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD043839L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-043839-L
STATE LICENSE
PA
Enumeration date
03/26/2013
Last updated
03/26/2013
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