A.W.C. Fairclough MD PC
Internal Medicine in Pontiac, MI. Organization (NPI-2).
NPI number1104144526
StatusActive
Last updated in NPPESJul 27, 2010
Details
- NPI
- 1104144526
- Entity type
- Organization (NPI-2)
- Legal business name
- A.W.C. Fairclough MD PC
- Organization subpart
- No
- Enumeration date
- May 10, 2010
- Last updated
- Jul 27, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | AF036119 | MI | Yes |
| 207RG0100X | Internal Medicine, Gastroenterology | AF036119 | MI |
Practice location
989 University DrSuite 107
Pontiac, MI 48342-1885
Phone 248-334-4773 · Fax 248-334-8230
Mailing address
989 University DrSuite 107
Pontiac, MI 48342-1885
Phone 248-334-4773 · Fax 248-334-8230
Authorized official
Anthony Fariclough
President
2483344773
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