Healthcare Provider Details

I. General information

NPI: 1063096238
Provider Name (Legal Business Name): ALEXIS FABER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 COOLIDGE HWY STE 220
TROY MI
48084-7068
US

IV. Provider business mailing address

1380 COOLIDGE HWY STE 220
TROY MI
48084-7068
US

V. Phone/Fax

Practice location:
  • Phone: 248-825-3764
  • Fax: 833-391-2161
Mailing address:
  • Phone: 248-825-3764
  • Fax: 833-391-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4301517790
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301517790
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: