Individual
DR. ROSS M FASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
072580
GA
208000000X
Pediatrics Physician
MD036088
DC
2080P0207X
Pediatric Hematology & Oncology Physician
072580
GA
Other
Enumeration date
05/04/2008
Last updated
08/24/2018
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