A.W.C. Fairclough MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

AF036119 Issued in MI

Legal business name

A.W.C. FAIRCLOUGH MD PC

Practice address

989 University Dr
Suite 107
Pontiac, MI 48342-1885

Phone

(248) 334-4773

Fax

(248) 334-8230

NPI assigned

May 10, 2010

Last updated

Jul 27, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Fariclough, MD

Title

President

Phone

(248) 334-4773

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1104144526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "address_2": "SUITE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-334-4773",
            "fax_number": "248-334-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "address_2": "SUITE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-334-4773",
            "fax_number": "248-334-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.W.C. FAIRCLOUGH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "FARICLOUGH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-334-4773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "AF036119",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "AF036119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0637997",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.