Individual
JAY R. FARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050
Mailing address
55 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
MD-14450
HI
207Q00000X
Family Medicine Physician
Primary
MD14450
HI
207Q00000X
Family Medicine Physician
MD151178
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07129001
—
HI
Enumeration date
02/05/2008
Last updated
07/19/2021
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