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General NPI Number Information
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NPI Number | 1417903998
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Entity Type | Individual
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Provider Name | LOUIS G. FARES II MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 1 CAPITAL WAY WOUND CARE CENTER
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City | PENNINGTON
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State | NJ
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Zip | 08534-2520
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Country | US
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Telephone | 609-537-7457
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Fax | 609-537-7189
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Provider Business Mailing Address
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Address Line | 1 CAPITAL WAY
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City | PENNINGTON
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State | NJ
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Zip | 08534-2520
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Country | US
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Telephone | 609-537-7457
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Fax | 609-537-7189
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MA039515
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License Number State | NJ
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