MEDICARE: MARGARET P. FANNEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	0904002720	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	320781	OTHER		BCBS

General Provider Information

NPI Number	:	1649381625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET P. FANNEY

Provider Business Mailing Address
First Line	:	4356 BONNEY RD
Second Line	:	SUITE 2-101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1200
Country	:	US
Telephone Number	:	757-498-1135
Fax Number	:	757-498-7018

Provider Business Practice Location Address
First Line	:	4356 BONNEY RD
Second Line	:	SUITE 2-101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1200
Country	:	US
Telephone Number	:	757-498-1135
Fax Number	:	757-498-7018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ MARGARET P. FANNEY ” Practice Location

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