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NPI Code Detail

MEDICARE: CARA FANNING MD

MEDICARE:   CARA  FANNING  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
1207R00000XInternal Medicine Physician11377NV
2207RI0200XInfectious Disease Physician11377NV

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 : 1841288107
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARA FANNING MD
Provider Business Mailing Address
First Line : 7021 SADDLE BACK PEAK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89166-7127
Country : US
Telephone Number : 702-287-0748
Fax Number :
Provider Business Practice Location Address
First Line : 3483 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3314
Country : US
Telephone Number : 702-399-3299
Fax Number : 702-252-4405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 01/07/2020

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Directions to “ CARA FANNING MD” Practice Location

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