Individual
MR. MICHAEL JONVIER FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5680 FULTON INDUSTRIAL BLVD SW, ATLANTA, GA 30336-2659
(404) 346-3471
Mailing address
177 MOURY AVE SW APT 2305, ATLANTA, GA 30315-3436
(917) 736-2507
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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