Individual
DR. JOHN ALEXANDER FANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(864) 223-3070
(864) 223-1396
Mailing address
234 WATERFORD PKWY, ORANGEBURG, SC 29118-9067
(803) 536-5122
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
17118
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171183
—
SC
Enumeration date
04/14/2006
Last updated
11/17/2016
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