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NPI Code Detail

MEDICARE: DR. EDGAR CECIL FEARNOW III M.D.

MEDICARE: DR. EDGAR CECIL FEARNOW III M.D.
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
12085R0202XDiagnostic Radiology PhysicianMD052054LPA
22085R0204XVascular & Interventional Radiology PhysicianMD052054LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123-3102793OTHERPATAX ID - LANCASTER PET IMAGING
2231855378OTHERPATAX ID - LANC RADIOLOGY
333-1011386OTHERPATAX ID - MRI GROUP

General Provider Information

NPI Number : 1174526297
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDGAR CECIL FEARNOW III M.D.
Provider Business Mailing Address
First Line : PO BOX 4216
Second Line :
City : LANCASTER
State : PA
Zip : 17604-4216
Country : US
Telephone Number : 717-394-6028
Fax Number : 717-394-9223
Provider Business Practice Location Address
First Line : 555 N DUKE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-394-9223
Fax Number : 717-394-9223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 12/01/2023

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