Individual
DR. JOHN ANDERSON FAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
200001199779
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240001710
RAILROAD MEDICARE
NC
01
—
31036
BCBS
NC
01
—
60623
MEDCOST
NC
05
—
8931036
—
NC
01
—
912
PARTNERS
NC
Enumeration date
05/04/2006
Last updated
12/17/2012
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