Individual
DR. FRANK STRAIT FAIREY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 WINGO WAY, SUITE 207, MT PLEASANT, SC 29464-1810
(843) 884-5101
(843) 606-7997
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06394
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063941
—
SC
01
—
080029143
RR MEDICARE
SC
01
—
080180702
RR MEDICARE
SC
01
—
P00739546
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
05/10/2006
Last updated
10/29/2020
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