Fanning, Walter Lee
Fanning, Walter Lee is an individual health care provider with primary practice located at 200 Medical Park Dr Ste 280 Carolinas Medical Center North East, Concord NC 28025-0935. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Fanning, Walter Lee can be contacted via phone (704) 403-1766.Contact Information
Primary practice address
200 Medical Park Dr Ste 280 Carolinas Medical Center North East
Concord NC 28025-0935
Phone: (704) 403-1766
Fax: (704) 403-1096
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 2006-00672 | North Carolina |
Profile Details
NPI number | 1639146780 |
---|---|
LBN Legal business name | Fanning, Walter Lee |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 7th, 2006 |
Last updated | Jul 13th, 2010 - about 14 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 | 1639146780 | NPPES |
North Carolina | Other | 1527547 | CIGNA |
North Carolina | Other | 00339806 | CIGNA |
North Carolina | Other | 142K2 | CIGNA |
North Carolina | Other | 2055819A | CIGNA |
North Carolina | Other | 190800 | CIGNA |
North Carolina | Other | 808032 | CIGNA |
North Carolina | Other | 4302912 | CIGNA |
North Carolina | Other | 232009 | CIGNA |
North Carolina | MEDICAID | 5903747 | CIGNA |
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