Individual
DR. CARY NELSON FISHBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7363 WALKER AVE, GLOUCESTER, VA 23061-6119
(804) 695-0305
(804) 695-0804
Mailing address
PO BOX 800, GLOUCESTER, VA 23061-0800
(804) 695-0305
(804) 695-0804
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101026966
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006715061
—
VA
Enumeration date
08/23/2005
Last updated
05/21/2008
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