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NPI Code Detail

MEDICARE: CHRIS D FENNELL MD

MEDICARE:   CHRIS D FENNELL  MD
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
1207L00000XAnesthesiology Physician26970SC
2207L00000XAnesthesiology Physician0101235889VA

Other Identifiers

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

General Provider Information

NPI Number : 1194795492
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRIS D FENNELL MD
Provider Business Mailing Address
First Line : PO BOX 1657
Second Line :
City : ANDERSON
State : SC
Zip : 29622-1657
Country : US
Telephone Number : 864-225-4601
Fax Number : 864-225-6998
Provider Business Practice Location Address
First Line : 800 N FANT ST
Second Line :
City : ANDERSON
State : SC
Zip : 29621-5708
Country : US
Telephone Number : 864-225-4601
Fax Number : 864-225-6998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 10/02/2007

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Directions to “ CHRIS D FENNELL MD” Practice Location

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