Individual
DR. JOHN M FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8 MORTON AVE, SUITE 303, RIDLEY PARK, PA 19078-2210
(610) 595-6850
(610) 595-6892
Mailing address
8 MORTON AVE, SUITE 303, RIDLEY PARK, PA 19078-2210
(610) 595-6850
(610) 595-6892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS003967L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001454661
—
PA
Enumeration date
10/23/2006
Last updated
09/21/2012
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