Fishburne, Cary Nelson
Fishburne, Cary Nelson is an individual health care provider with primary practice located at 7363 Walker Ave , Gloucester VA 23061-6119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fishburne, Cary Nelson can be contacted via phone (804) 695-0305.Contact Information
Primary practice address
7363 Walker Ave
Gloucester VA 23061-6119
Phone: (804) 695-0305
Fax: (804) 695-0804
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101026966 | Virginia |
Profile Details
| NPI number | 1669464988 |
|---|---|
| LBN Legal business name | Fishburne, Cary Nelson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2005 |
| Last updated | May 21st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669464988 | NPPES |
| Virginia | MEDICAID | 006715061 |
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