Individual
DR. JAMES LOUIS FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
5526B CAROLINA BEACH RD, WILMINGTON, NC 28412-2606
(910) 452-7225
(910) 452-7229
Mailing address
5526B CAROLINA BEACH RD, WILMINGTON, NC 28412-2606
(910) 452-7225
(910) 452-7229
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1188
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09273
BCBS
NC
01
—
2228835
UNITED HEALTHCARE
NC
01
—
562238345
VSP
NC
05
—
7909273
—
NC
01
—
P00004683
RR MEDICARE
NC
Enumeration date
02/23/2007
Last updated
02/03/2011
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