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NPI Code Detail

MEDICARE: DR. JOHN PAGANOTTI M.D.

MEDICARE: DR. JOHN PAGANOTTI 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
1207R00000XInternal Medicine Physician4301115737MI
2207R00000XInternal Medicine PhysicianMD191031OR
3207R00000XInternal Medicine Physician2022-03040NC

General Provider Information

NPI Number : 1861888042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN PAGANOTTI M.D.
Provider Business Mailing Address
First Line : PO BOX 40908
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28309-0908
Country : US
Telephone Number :
Fax Number : 949-703-7617
Provider Business Practice Location Address
First Line : 1638 OWEN DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-5610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2015
Last Update Date : 05/13/2026

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