Individual
DR. MARY ELIZABETH FAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3825 TEAYS VALLEY ROAD, SUITE 100, HURRICANE, WV 25526
(304) 757-0050
(304) 757-0061
Mailing address
PO BOX 1320, SAINT ALBANS, WV 25177-1320
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
20376
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001723914
BLUE CROSS BLUE SHIELD
WV
01
—
001723915
BLUE CROSS BLUE SHIELD
WV
05
—
3005015-000
—
WV
01
—
753146655
P.E.I.A./ACORDIA
WV
01
—
7560573
AETNA
WV
01
—
P01050843
RAILROAD
—
Enumeration date
07/12/2006
Last updated
01/21/2015
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