Individual
JONATHAN ANDREW FAUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4835
(763) 559-3779
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
49717
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371692000
—
MN
Enumeration date
03/28/2007
Last updated
08/17/2010
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