Healthcare Provider Details

I. General information

NPI: 1528241072
Provider Name (Legal Business Name): GEORGE OSWALD FAERBER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7547 DUBLIN RD
DELAWARE OH
43015-9237
US

IV. Provider business mailing address

7547 DUBLIN RD
DELAWARE OH
43015-9237
US

V. Phone/Fax

Practice location:
  • Phone: 740-881-5574
  • Fax: 740-881-5574
Mailing address:
  • Phone: 740-881-5574
  • Fax: 740-881-5574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number34-001716
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number34-001716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: