Healthcare Provider Details

I. General information

NPI: 1215034780
Provider Name (Legal Business Name): CAROL J FABIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SHAWNEE MISSION PKWY SUITE 210 MS 5003
WESTWOOD KS
66205-2005
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY SUITE 210, MS 5003
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6029
  • Fax:
Mailing address:
  • Phone: 913-588-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number04-16438
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: