Fagg, John Anderson
Fagg, John Anderson is an individual health care provider with primary practice located at 2901 Maplewood Ave , Winston-Salem NC 27103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Fagg, John Anderson can be contacted via phone (336) 765-8620.Contact Information
Primary practice address
2901 Maplewood Ave
Winston-Salem NC 27103
Phone: (336) 765-8620
Fax: (336) 768-6236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 200001199779 | North Carolina |
Profile Details
| NPI number | 1316905508 |
|---|---|
| LBN Legal business name | Fagg, John Anderson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Dec 17th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316905508 | NPPES |
| North Carolina | Other | 240001710 | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 8931036 | RAILROAD MEDICARE |
| North Carolina | Other | 60623 | RAILROAD MEDICARE |
| North Carolina | Other | 31036 | RAILROAD MEDICARE |
| North Carolina | Other | 912 | RAILROAD MEDICARE |
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