DR. BRENT CABELL FAULKNER, MD - NPI NUMBER 1912999657

Summary

Provider Name: DR. BRENT CABELL FAULKNER, MD

NPI Number: 1912999657

Clasification: Plastic Surgery (208200000X)

Organization: AMBULATORY PLASTIC SURGERY CENTER ASSOC., CHTD.

Address:
15245 SHADY GROVE RD
SUITE 155
ROCKVILLE, MD
ZIP 20850

Phone Number: (240) 912-4708



Detailed Information

DR. Brent Cabell Faulkner, MD is a plastic surgeon in Rockville, MD with 15 years of experience. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. The assigned NPI number for this provider is 1912999657 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 1999

The provider's business address is:

15245 SHADY GROVE RD
SUITE 155
ROCKVILLE, MD
ZIP 20850-222
Phone: (240) 912-4708
Fax: (240) 912-6992

The enumeration date for this NPI number is 8/18/2005 and was last updated on 4/9/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208200000X Plastic Surgery D0063076 MD Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 017815A44 OTHER MD MEDICARE ID
2 I39789 MEDICARE UPIN MD

NPI Record

No. Field Name Field Value
1 NPI 1912999657
2 Entity Type Code 1
3 Provider Last Name Legal Name FAULKNER
4 Provider First Name BRENT
5 Provider Middle Name CABELL
6 Provider Name Prefix Text DR.
7 Provider Credential Text MD
8 Provider First Line Business Practice Location Address 15245 SHADY GROVE RD
9 Provider Second Line Business Practice Location Address SUITE 155
10 Provider Business Practice Location Address City Name ROCKVILLE
11 Provider Business Practice Location Address State Name MD
12 Provider Business Practice Location Address Postal Code 208503222
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 2409124708
15 Provider Business Practice Location Address Fax Number 2409126992
16 Provider Enumeration Date 8/18/2005
17 Last Update Date 4/9/2014
18 Provider Gender Code M
19 Healthcare Provider Taxonomy Code 1 208200000X
20 Provider License Number 1 D0063076
21 Provider License Number State Code 1 MD
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 017815A44
24 Other Provider Identifier Type Code 1 01
25 Other Provider Identifier State 1 MD
26 Other Provider Identifier Issuer 1 MEDICARE ID
27 Other Provider Identifier 2 I39789
28 Other Provider Identifier Type Code 2 02
29 Other Provider Identifier State 2 MD
30 Is Sole Proprietor N

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This page was last updated on: 4/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.