Healthcare Provider Details

I. General information

NPI: 1346340825
Provider Name (Legal Business Name): ROBIN FANNING DARNELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MACCORKLE AVE SE
CHARLESTON WV
25304-1835
US

IV. Provider business mailing address

2585 3RD AVE
HUNTINGTON WV
25703-1642
US

V. Phone/Fax

Practice location:
  • Phone: 304-925-0392
  • Fax: 304-925-0396
Mailing address:
  • Phone: 304-697-1396
  • Fax: 304-697-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18615
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: