Healthcare Provider Details

I. General information

NPI: 1417166265
Provider Name (Legal Business Name): CHRISTOPHER A FAUST D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 BOYSON RD
HIAWATHA IA
52233-2362
US

IV. Provider business mailing address

3964 MACBRIDE PL NE
SOLON IA
52333-9406
US

V. Phone/Fax

Practice location:
  • Phone: 319-743-7300
  • Fax:
Mailing address:
  • Phone: 635-940-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOP60402973
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDO3991
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number3857
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number3857
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: