Provider Demographics
NPI:1194163469
Name:FAIG, JENNIFER ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:FAIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COLUMBIAN ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1601
Mailing Address - Country:US
Mailing Address - Phone:781-624-5000
Mailing Address - Fax:781-624-4840
Practice Address - Street 1:101 COLUMBIAN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-624-5000
Practice Address - Fax:781-624-4840
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256028207R00000X
MA26631207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology