Provider Demographics
NPI:1528241072
Name:FAERBER, GEORGE OSWALD (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:OSWALD
Last Name:FAERBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7547 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9237
Mailing Address - Country:US
Mailing Address - Phone:740-881-5574
Mailing Address - Fax:740-881-5574
Practice Address - Street 1:7547 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9237
Practice Address - Country:US
Practice Address - Phone:740-881-5574
Practice Address - Fax:740-881-5574
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-001716207U00000X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0221585Medicaid
OHA68403Medicare UPIN
OHFA0015183Medicare PIN