Individual
PEDRO CERVANTES FANNING
Active
Individual
PEDRO CERVANTES FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036129100
IL
207W00000X
Ophthalmology Physician
Primary
2016-01762
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19N11
BCBSNC
NC
01
—
7151944
CIGNA
—
01
—
9973753
AETNA
—
05
—
NC2885
—
SC
01
—
P01840923
RAILROAD MEDICARE
NC
Enumeration date
10/07/2008
Last updated
04/27/2021
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