Individual
PATRICK STANLEY FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3909 SUNSET RIDGE RD, SUITE 103, RALEIGH, NC 27607-6667
(919) 788-0505
(919) 788-0519
Mailing address
2208 MISSKELLY DR, RALEIGH, NC 27612-5817
(919) 510-0637
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9400787
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8931567
—
NC
Enumeration date
06/02/2006
Last updated
05/13/2008
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