Individual
MATTHEW JOSEPH FANELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
66 PARKWAY LN STE 101A, FISHERSVILLE, VA 22939-2385
(540) 451-2833
(540) 451-2837
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101276020
VA
207N00000X
Dermatology Physician
036.137205
IL
207N00000X
Dermatology Physician
51923
SC
207N00000X
Dermatology Physician
71653-20
WI
Other
Enumeration date
04/21/2010
Last updated
08/11/2022
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