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General NPI Number Information
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NPI Number | 1811922362
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Entity Type | Individual
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Provider Name | MARY ELIZABETH FAW M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 3825 TEAYS VALLEY ROAD SUITE 100
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City | HURRICANE
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State | WV
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Zip | 25526
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Country | US
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Telephone | 304-757-0050
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Fax | 304-757-0061
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Provider Business Mailing Address
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Address Line | PO BOX 1320
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City | SAINT ALBANS
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State | WV
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Zip | 25177-1320
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Country | US
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Telephone | 304-388-1724
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Fax | 304-388-1721
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 20376
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License Number State | WV
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