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NPI Code Detail

MEDICARE: DR. JAMES E FAYSSOUX M.D.

MEDICARE:  DR. JAMES E FAYSSOUX  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician21496SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00457514OTHERSCRAILROAD MEDICARE ID
3P00739548OTHERSCRAILROAD MEDICARE ID-RSFPN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407808926
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES E FAYSSOUX M.D.
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 843-789-1620
Fax Number : 843-724-2440
Provider Business Practice Location Address
First Line : 615 WESLEY DR
Second Line : SUITE 200
City : CHARLESTON
State : SC
Zip : 29407-7204
Country : US
Telephone Number : 843-571-6880
Fax Number : 843-571-1387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 10/29/2020

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