Individual
DR. GREGORY LEE FAUTHEREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD.203804
LA
207T00000X
Neurological Surgery Physician
ME105666
FL
207T00000X
Neurological Surgery Physician
TRN6823
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001635000
—
FL
05
—
2112562
—
LA
Enumeration date
10/27/2006
Last updated
03/25/2020
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