Organization
FANOUS CLINIC MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANY FARAG (OWNER)
(980) 224-7288
Entity
Organization
Contact information
Practice address
10926 S TRYON ST STE D, CHARLOTTE, NC 28273-4154
(980) 224-7288
(800) 507-2885
Mailing address
10926 S TRYON ST STE D, CHARLOTTE, NC 28273-4154
(980) 224-7288
(800) 507-2885
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
01/26/2023
Last updated
08/16/2024
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