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:
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Health care specialties

SpecialtyCodeLicense #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 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 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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