Individual
TIMOTHY MILTON FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1255
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5001443
NC
Other
Enumeration date
08/13/2006
Last updated
05/04/2023
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