Individual
ROBERT BRIAN FAZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1718 E 4TH ST, SUITE 501, CHARLOTTE, NC 28204-3261
(704) 343-9800
(704) 347-2011
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 343-9800
(704) 347-2011
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9500897
NC
207RI0011X
Interventional Cardiology Physician
0095-00897
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8931433
—
NC
05
—
N00897
—
SC
Enumeration date
07/29/2005
Last updated
08/25/2022
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