Fanney, Daryl R

Fanney, Daryl R is an individual health care provider with primary practice located at 4668 Pembroke Blvd Suite 117, Virginia Beach VA 23455-6423. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fanney, Daryl R can be contacted via phone (757) 671-1144.

Contact Information

Primary practice address
4668 Pembroke Blvd Suite 117 Virginia Beach VA 23455-6423
Phone: (757) 671-1144
Fax: (757) 671-1265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101045547 Virginia

Profile Details

NPI number 1922081538
LBN Legal business name Fanney, Daryl R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Apr 22nd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922081538 NPPES
North Carolina MEDICAID 890524Y
North Carolina MEDICAID 007213905
North Carolina Other 380544

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