Provider Demographics
NPI:1144515651
Name:FAUST, TIMOTHY R (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:R
Last Name:FAUST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3525
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:4092 FOXWOOD DR
Practice Address - Street 2:STE 101
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5225
Practice Address - Country:US
Practice Address - Phone:757-686-3525
Practice Address - Fax:757-686-0541
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT200246207P00000X
PAMD452415207P00000X
VA0101257727207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine