MEDICARE: CLIFFORD EDWARD FAULL MD

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
1	207X00000X	Orthopaedic Surgery Physician	20269	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1407859044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD EDWARD FAULL MD

Provider Business Mailing Address
First Line	:	80 HEALTHCARE DR
Second Line	:	STE 203
City	:	SYLVA
State	:	NC
Zip	:	28779-5146
Country	:	US
Telephone Number	:	828-586-5531
Fax Number	:	828-586-5759

Provider Business Practice Location Address
First Line	:	80 HEALTHCARE DR
Second Line	:	STE 203
City	:	SYLVA
State	:	NC
Zip	:	28779-5146
Country	:	US
Telephone Number	:	828-586-5531
Fax Number	:	828-586-5759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/02/2008

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Directions to “ CLIFFORD EDWARD FAULL MD” Practice Location

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